肺部超声在新生儿呼吸窘迫综合征诊断中的应用价值

Value of lung ultrasound in the diagnosis of neonatal respiratory distress syndrome

目的分析新生儿呼吸窘迫综合征(NRDS)超声评分与X线分级、临床指标的关联性,探讨肺部超声对NRDS的诊断价值。方法收集2016年5月至2017年6月南京医科大学第一附属医院行肺部超声检查的80例新生儿,其中NRDS 44例,对患儿进行肺脏超声评分(LUS)。前胸壁和后胸壁评分的差异采用独立样本t检验;LUS与胸部X线分级的相关性采用Spearman相关分析;与氧合指数(PaO2/FiO2)及呼气末正压通气(PEEP)的相关性采用Pearson相关分析。结果 44例患儿的LUS总分平均为(18.89±10.43)分,后胸壁LUS平均为(8.59±3.14)分,显著高于前胸壁的(4.70±3.90)分,差异有统计学意义(P <0.05)。随着胸部X线分级越高,LUS越高,LUS与胸部X线分级呈正相关(r=0.924,P <0.05)。LUS总分与氧合指数呈负相关(r=-0.524,P <0.01),与PEEP呈正相关(r=0.662,P <0.01)。结论肺部超声在新生儿呼吸窘迫综合征诊断中具有一定的应用价值,LUS与胸部X线分级呈正相关,其可作为诊断新生儿呼吸窘迫综合征的重要补充。

Objective To analyze the correlation of the lung ultrasound score(LUS)with X-ray classification and clinical indicators in neonatal respiratory distress syndrome(NRDS),and to explore the diagnostic value of pulmonary ultrasound for NRDS.Methods From May2016to June2017,80newborns who underwent lung ultrasound examination in the First Affiliated Hospital of Nanjing Medical University were collected in this study,including44cases of NRDS.The difference between the score of anterior chest wall and posterior chest wall was analyzed by independent sample t test.LUS and X-ray grading were analyzed by Spearman correlation.The correlation between LUS and oxygenation index(PaO2/FiO2)and positive end expiratory pressure(PEEP)was analyzed by Pearson correlation analysis.Results The total LUS in44cases was(18.89±10.43),and LUS of the posterior wall of the chest was(8.59±3.14),which was significantly higher than that of the anterior chest wall(4.70±3.90).The difference was statistically significant(P<0.05).There was a positive correlation between LUS and X-ray grading(r=0.924,P<0.05).The total LUS was negatively correlated with oxygenation index(r=-0.524,P<0.01),while positively correlated with PEEP(r=0.662,P<0.01).Conclusion Pulmonary ultrasound is of value in the diagnosis of NRDS.LUS is positively correlated with the X-ray classification,which is an important supplement for the diagnosis of NRDS.