肺脏超声在新生儿胎粪吸入综合征的诊断价值

Diagnostic Value of Pulmonary Ultrasound in Neonatal Meconium Aspiration Syndrome

目的探究新生儿胎粪吸入综合征患者接受肺脏超声诊断的价值。方法方便选取胎粪吸入综合征新生儿50例为实验组,所选时间为2017年2月—2018年5月,其均经胸部X线检查并结合临床表现、病史等确诊,同时选取同期无肺部病变新生儿50例作为对照组,其均接受肺脏超声检查,对其检查的结果进行分析。结果无肺部病变新生儿经超声检查显示其正常肺组织为低回声,可清晰显示A-线以及胸膜线,实时超声可见少数或不存在B-线,但是不存在肺实变、胸腔积液等情况;胎粪吸入综合征新生儿经超声检查显示,所有新生儿均存在支气管充气征,双侧肺脏的相关病变范围可以存在一定的差异性,同一侧肺野,也可出现不同大小的实变区。A线消失、胸膜线异常可出现在所有胎粪吸入综合征新生儿中,若其存在大面积严重肺不张,则实施实时超声,可见动态的支气管充气征或肺搏动的情况。部分新生儿可见胸腔积液。在实变区以外的肺野,其主要表现为B-线或AIS;实验组胎粪吸入综合征新生儿的B-线/AIS检出率(100.00%)、肺搏动检出率(8.00%)、肺不张检出率(18.00%)、胸腔积液检出率(14.00%)、A-线消失检出率(100.00%)、胸膜线异常检出率(100.00%)、肺实变检出率(100.00%)均明显高于对照组无肺部病变的新生儿,差异有统计学意义(B-线/AIS相比,χ^2=58.7302,P=0.000;肺搏动相比,χ^2=4.1667,P=0.041;肺不张相比,χ^2=9.8901,P=0.002;胸腔积液相比,χ^2=7.5269,P=0.006;A-线消失相比,χ^2=100.0000,P=0.000;胸膜线异常相比,χ^2=100.0000,P=0.000;肺实变相比,χ^2=100.0000,P=0.000)。结论胎粪吸入综合征新生儿接受超声检查,可动态了解其病情变化,意义重大。

Objective To investigate the value of ultrasound diagnosis of neonatal meconium aspiration syndrome in patients with lung.Methods A total of 50 neonates with meconium aspiration syndrome were enrolled in the experimental group.The selected time was from February 2017 to May 2018.All patients were diagnosed by chest X-ray and combined with clinical manifestations and medical history.50 cases of neonatal lesions were used as control group,and all of them underwent ultrasound examination of the lungs,and the results of the examination were analyzed.Results Ultrasound examination of neonates without pulmonary lesions showed that the normal lung tissue was hypoechoic,and the A-line and pleural line were clearly displayed.Real-time ultrasound showed little or no B-line,but there was no lung consolidation or pleural effusion;neonatal examination of meconium aspiration syndrome showed that all newborns have bronchial aeration,and the range of lesions in bilateral lungs may be different.The same side of the lung field may also have different sizes.A line disappeared and pleural line abnormalities may occur in all neonatal fecal inhalation syndrome.If there is a large area of severe atelectasis,real-time ultrasound is performed to show dynamic bronchial aeration or pulmonary pulsation.Some newborns have pleural effusions.In the lung field outside the consolidation zone,the main performance is B-line or AIS;the detection rate of B-line/AIS in neonates with experimental meconium aspiration syndrome(100.00%),and the detection rate of pulmonary pulsation(8.00%),atelectasis detection rate(18.00%),pleural effusion detection rate(14.00%),A-line disappearance detection rate(100.00%),pleural line abnormal detection rate(100.00%),lung consolidation The detection rate(100.00%)was significantly higher than that of the control group without lung lesions.The difference was statistically signif icant(B-line/AIS compared,χ^2=58.730 2,P=0.000;compared with lung pulsation,χ^2=4.166 7,P=0.041;compared with lung atelectasis,χ^2=9.890 1,P=0.002;compared with pleural effusion,χ^2=7.526 9,P=0.006;A-line disappeared compared toχ^2=100.000 0,P=0.000;compared with pleural line abnormality,χ^2=100.000 0,P=0.000;compared with lung consolidation,χ^2=100.000 0,P=0.000).Conclusion Neonatal examination of meconium aspiration syndrome can be used to dynamically understand the changes in the condition,which is of great significance.