肺超声评分评估新生儿呼吸窘迫综合征及预后的价值

The value of lung ultrasound score in evaluating neonatal respiratory distress syndrome and prognosis

目的分析新生儿呼吸窘迫综合征(NRDS)的肺超声图像特点,以及肺超声评分(LUS)对NRDS病情评估的可行性。方法选取我院早产儿病房收治的80例NRDS患儿为观察组,根据病症严重程度分为非危重组(26例)、危重组(34例)和极危重组(20例);同时期收治的非肺部疾病的早产儿60例为对照组。分别对两组治疗前行肺部超声检查,比较两组LUS的差异,观察组治疗后72 h行超声复查,比较治疗前后LUS的差异。结果1)NRDS组肺部超声主要表现为肺实变、胸膜线异常、A线模糊或消失、胸腔积液、白肺及肺搏动减弱或消失等;2)观察组LUS明显高于对照组,差异有统计学意义(P<0.05);极危重组LUS明显高于危重组,危重组LUS明显高于非危重组,组间LUS比较差异有统计学意义(P<0.05);3)NRDS组治疗72 h后,肺实变及支气管充气征减轻,胸膜线清晰光滑,A线逐渐出现,LUS较治疗前明显减低,差异有统计学意义(P<0.05)。结论NRDS以早产儿多见,具有发病急、进展快的特点,对患儿行LUS可有效评估病情的严重程度,有重要的临床意义。

Objective To analyze the characteristics of pulmonary ultrasound images of neonatal respiratory distress syndrome(NRDS)and the feasibility of lung ultrasound score(LUS)for the assessment of NRDS.Methods 80 cases of NRDS admitted to the premature infant ward in our hospital were selected as the observation group,which were divided into non-critical group(26 cases),critical group(34 cases)and extremely critical group(20 cases)according to the severity of the disease.During the same period,60 preterm infants without pulmonary disease were treated as control group.Lung ultrasonography was performed in the two groups before treatment to compare the difference of LUS between the two groups.The observation group underwent ultrasound review 72 h after treatment to compare the difference of LUS before and after treatment.Results 1)lung ultrasound in NRDS group mainly showed lung consolidation,abnormal pleural line,blurred or disappeared line A,pleural effusion,weakened or disappeared white lung and lung beat,etc;2)LUS in the observation group was significantly higher than that in the control group,with statistically significant difference(P<0.05).LUS in the extremely critical group was significantly higher than that in the critical group,while LUS in the critical group was significantly higher than that in the non-critical group,with statistically significant difference(P<0.05);3)after 72 h of treatment in NRDS group,pulmonary consolidation and bronchial inflation signs were alleviated,pleural line was clear and smooth,and line A gradually appeared,and LUS was significantly decreased compared with that before treatment,with statistically significant difference(P<0.05).Conclusion NRDS is common in premature infants,and it has the characteristics of rapid onset and rapid progression.Therefore,LUS can effectively evaluate the severity of the disease in infants,which has important clinical significance.