肺脏超声在小儿重症肺炎纤维支气管镜肺泡灌洗前后的应用价值研究

Application value of lung ultrasound in children with severe pneumonia before and after bronchoscopy alveolar lavage

目的分析肺部超声在小儿重症肺炎纤维支气管镜肺泡灌洗前后的应用价值。方法选取2017年1月至2021年1月本院收治的50例接受纤维支气管镜肺泡灌洗的重症肺炎住院患儿作为研究对象,随机分为观察组和对照组,每组25例。观察组以胸部CT检查为金标准,灌洗前和治疗后出院前进行肺脏超声检查。对照组灌洗前进行传统胸部超声及胸部CT检查,治疗后出院前进行胸部超声及胸部CT检查,分析胸部超声结果。比较两组患儿灌洗前后超声表现,分析肺超声评分在重症肺炎患儿病情严重程度评估中的应用价值。结果经纤维支气管镜肺泡灌洗治疗后,观察组患儿肺实变影明显变小,胸腔积液消失。对照组患儿灌洗前后胸腔积液明显减少。肺超声评分与住院时间(r=0.608,P=0.000)、呼吸频率(r=0.559,P=0.000)呈正相关,与氧饱和度(r=-0.482,P=0.004)呈负相关。将肺超声评分20.5作为预测值,肺超声评分的灵敏度为81.28%,特异度为63.17%。结论肺脏超声能对小儿重症肺炎的病情严重程度进行定量评估,预测患儿预后,具有临床推广价值。

Objective To analyze the application value of lung ultrasound before and after bronchoalveolar lavage in children with severe pneumonia.Methods From January 2017 to January 2021,50 hospitalized children with severe pneumonia who received bronchoalveolar lavage by fiberoptic bronchoscope were selected as the research subjects and they were randomly divided into observation group and control group,with 25 cases in each group.In the observation group,chest CT examination was taken as the gold standard,lung ultrasound examination was performed before lavage and before discharge after treatment.The control group received conventional chest ultrasound and chest CT examination before lavage,and chest ultrasound and chest CT examination before discharge after lavage.The ultrasound performance of the two groups before and after lavage was compared,and the application value of lung ultrasound score in the evaluation of the severity of severe pneumonia in children was analyzed.Results After treatment,the lung consolidation shadow of the observation group was significantly smaller,and the pleural effusion was significantly disappeared.In the control group,pleural effusion was significantly reduced before and after lavage.Lung ultrasound score was positively correlated with hospital stay(r=0.608,P=0.000)and respiratory rate(r=0.559,P=0.000),and negatively correlated with oxygen saturation(r=-0.482,P=0.004).The sensitivity and specificity of lung ultrasound score were 81.28%and 63.17%respectively when the lung ultrasound score was 20.5.Conclusion Lung ultrasound can quantitatively evaluate the severity of severe pneumonia in children,and can predict the prognosis of children,which has clinical value.