肺部超声与X线在新生儿呼吸窘迫综合征中的诊断价值对比研究

Comparative study of diagnostic value of pulmonary ultrasonography and X-ray in neonatal respiratory distress syndrome

目的探讨肺部超声与X线胸片在新生儿呼吸窘迫综合征(NRDS)中的诊断价值。方法选取2016年1月至2017年6月该院新生儿重症监护室收治的伴有NRDS症状的新生儿198例为研究对象,对所有入选的新生儿进行肺部超声检查与X线胸片检查,以临床诊断结果为金标准,对比两种检查方法诊断NRDS与临床诊断结果的诊断符合率、特异度、灵敏度、阳性预测值、阴性预测值等。结果 198例入选患儿中,临床最终诊断为NRDS患儿132例,诊断为新生儿暂时性呼吸增快症42例,新生儿肺炎14例,其他10例;X线检查诊断为NRDS患儿120例;肺部超声诊断为NRDS患儿129例;肺部超声诊断NRDS与临床诊断符合率、特异度、灵敏度、阴性预测值均显著高于X线检查(P<0.05),两种检查方法诊断NRDS的阳性预测值对比,差异无统计学意义(P>0.05)。结论肺部超声诊断NRDS患儿较X线具有更高的准确率、特异度、灵敏度及阴性预测值,值得临床推广应用。

Objective To investigate the lung ultrasound and X-ray in neonatal respiratory distress syndrome(NRDS)diagnostic value.Methods A total of 198 newborns admitted to the NICU with RDS symptoms from January 2016 to June 2017 were selected as the research objects,the lung ultrasound and X-ray examination were conducted in all neonates,with the clinical diagnosis as the gold standard.A comparison of two methods in diagnosis of NRDS and clinical diagnosis results according to the diagnostic rate,specificity,sensitivity,positive predictive value,negative predictive value was conducted.Results A total of 198 cases of patients,clinical final diagnosis of 132 NRDS patients,diagnosed as neonatal transient tachypnea in 42 cases,14 cases of neonatal pneumonia,other 10 cases;X-ray diagnosis of 120 cases of children with NRDS;lung ultrasound diagnosis of 129 cases of NRDS patients with pulmonary;rate of ultrasonic diagnosis and clinical diagnosis of NRDS the specificity,sensitivity,negative predictive value was significantly higher than that of X-ray(P<0.05),two positive predictive value of the diagnosis of NRDS had no significant difference compared(P>0.05).Conclusion The diagnostic accuracy specificity,sensitivity and negative predictive value of lung ultrasound in children with NRDS are higher than those of X-ray.It is worthy of clinical application.