床旁高频超声技术在新生儿肺炎诊断中的临床价值及影像学特征

Clinical value and imaging features of bedside high-frequency ultrasound in the diagnosis of neonatal pneumonia

目的研究床旁高频超声技术运用于新生儿肺炎诊断的临床价值并总结其影像学特征。方法前瞻性收集于2018年1月至2020年1月期间在徐州医科大学附属徐州儿童医院确诊并接受治疗的312例新生儿肺炎患儿资料,采用随机数字表法将其分为研究组(床旁高频超声,n=156)与对照组(胸部X线检查,n=156)。观察比较床旁高频超声与X线对新生儿肺炎的检出情况,分析患儿超声影像学特征,并比较床旁高频超声与X线对新生儿肺炎的诊断效能。结果新生儿肺炎病理学检查显示,阳性142例,阴性14例;胸部X线检查阳性127例,阴性29例;床旁高频超声检查阳性140例,阴性16例。研究组的阳性检出率(89.74%,140/156)明显高于对照组(81.41%,127/156),差异有统计学意义(P<0.05);研究组诊断灵敏度为97.89%(139/142),特异度为92.86%(13/14),准确度为97.44%(152/156),阳性预测值为99.29%(139/140),阴性预测值为75.00%(12/16);对照组诊断灵敏度为85.92%(122/142),特异度为64.29%(9/14),准确度为83.97%(131/156),阳性预测值为96.06%(122/127),阴性预测值为31.03%(9/29);研究组检查新生儿肺炎的敏感度、准确度、特异度以及阴性预测值均高于对照组,差异均有统计学意义(P<0.05),但阳性预测值比较组间差异无统计学意义(P>0.05);床旁超声影像学结果显示140例阳性患儿中,肺泡间质综合征114例,A线消失110例,胸膜线异常108例,肺实变69例,胸腔积液10例,支气管充气征9例。结论床旁高频超声技术运用于新生儿肺炎诊断,表现出肺泡间质综合征、A线消失、胸膜线以及B线异常、肺实变等,其阳性检出率显著高于X线,适用于新生儿肺炎的临床诊断,具有较好的应用前景。

Objective To study the value of bedside high-frequency ultrasound in the diagnosis of neonatal pneumonia and summarize its imaging characteristics.Methods Prospectively collected data on 312 cases of neonatal pneumonia diagnosed and treated at Xuzhou Children's Hospital of Xuzhou Medical University from January 2018 to January 2020,and divided them into study groups using a random number table method(bedside High-frequency ultrasound,n=156)and the control group(chest X-ray examination,n=156).To observe and compare bedside high-frequency ultrasound and X-ray detection of neonatal pneumonia,analyze the ultrasound imaging characteristics of children,and compare the diagnostic efficiency of bedside high-frequency ultrasound and X-ray for neonatal pneumonia.Results Pathological examination of neonatal pneumonia showed that 142 cases were positive,14 cases were negative,127 cases were positive in chest X-ray examination,29 cases were negative,140 cases were positive in bedside high frequency ultrasonography,and 16 cases were negative.The positive detection rate of the study group was 89.74%.(140/156),higher than 81.41%(127/156)of the control group,the difference was statistically significant(P<0.05);the diagnostic sensitivity of the study group was 97.89%(139/142),and the specificity was 92.86%(13/14),the accuracy was 97.44%(152/156),the positive predictive value was 99.29%(139/140),the negative predictive value was 75.00%(12/16);the diagnostic sensitivity of the control group was 85.92%(122/142)),the specificity was 64.29%(9/14),the accuracy was 83.97%(131/156),the positive predictive value was 96.06%(122/127),and the negative predictive value was 31.03%(9/29);the sensitivity,accuracy,specificity,and negative predictive value of the study group for neonatal pneumonia were higher than those of the control group,and the differences were statistically significant(P<0.05),but there was no significant difference in the positive predictive value between the two groups(P>0.05).The results of paraultrasound imaging showed that among 140 positive patients,114 had alveolar interstitial syndrome,110 had disappearance of A-line,108 had abnormal pleural line,69 had pulmonary consolidation,10 had pleural effusion,and 9 had bronchial inflation.Conclusion Bedside high-frequency ultrasound technology is used in the diagnosis of neonatal pneumonia,showing alveolar interstitial syndrome,disappearance of A-line,abnormal pleural and B-line,lung consolidation,etc.,and its positive detection rate is significantly higher than that of X-ray.It is applicable It has good application prospects for the clinical diagnosis of neonatal pneumonia.