肺部超声联合肺潮气功能检查对新生儿肺炎的诊断

Pulmonary ultrasound combined with tidal breath pulmonary function examination in the diagnosis of neonatal pneumonia

目的研究肺部超声联合肺潮气功能检查在新生儿肺炎诊断中的临床应用价值。方法 2016年1月至2017年1月新生儿科收治的临床疑诊为肺炎的156例新生儿进行X线或CT、肺部超声及潮气功能检查。对其结果进行分析。结果 156例新生儿中,经临床及X线、CT检查综合诊断新生儿肺炎145例。以临床综合诊断为标准,对新生儿肺炎的诊断效能如下。(1)肺部超声检查:阳性130例,阴性8例,假阴性15例,假阳性3例,敏感性为89.6%,特异性为72.7%;(2)肺潮气功能检查:阳性145例,阴性9例,假阴性0例,假阳性2例,敏感性100%,特异性81.8%;(3)肺部超声联合肺潮气功能检查:阳性145例,阴性8例,假阴性0例,假阳性3例,敏感性100%,特异性72.7%。结论肺部超声检查作为避免X线辐射的影像学方法,适合应用于新生儿肺炎的诊断,其联合肺潮气功能检查能提高肺超声检查的敏感性。

Objective To investigate the diagnosis value of pulmonary ultrasound combined with tidal breath pulmonary function examination in neonatal pneumonia. Methods A total of 156 newborns who were suspected of pneumonia from January 2016 to January 2017 received X-ray or CT,pulmonary ultrasound and tidal breath pulmonary function examination,and the results were analyzed. Results Through the combination of clinical,X-ray,CT,pulmonary ultrasound and tidal breath pulmonary function examination,there were 145 cases diagnosed as neonatal pneumonia in 156 newborns.The diagnostic efficiency of neonatal pneumonia was evaluated by the clinical comprehensive diagnosis. Pulmonary ultrasound examination was positive in 130 cases,negative in 8 cases,false negative in 15 cases and false positive in 3 cases,and its sensitivity was 89. 6% while its specificity was 72. 7%. Pulmonary tidal function examination was positive in145 cases,negative in 9 cases,false positive in 2 cases and false negative in 0,and its sensitivity was 100% while its specificity was 81. 8%. The sensitivity and specificity of pulmonary ultrasound combined with tidal breath pulmonary function examination was 100% and 72. 7% respectively. Conclusions The pulmonary ultrasound examination is a suitable imaging method for the diagnosis of neonatal pneumonia while it could avoid X-ray radiation. The combination of tidal breath pulmonary function examination could improve the sensitivity of pulmonary ultrasound examination.