肺部超声动态评价支气管肺泡灌洗治疗感染性肺炎患儿的临床效果

Lung ultrasonography for dynamic observation of clinical effects of bronchoalveolar lavage in children with infectious pneumonia

目的观察肺部超声(LUS)动态评价支气管肺泡灌洗(BAL)治疗感染性肺炎患儿效果的价值。方法纳入30例接受BAL治疗的感染性肺炎患儿,分别于治疗前、治疗后(2~6天)及出院当天行LUS检查,观察肺部声像图表现并进行LUS评分,测量最高体温及氧合指数(PaO_(2)/FiO_(2)),分析LUS评分与PaO_(2)/FiO_(2)的相关性。结果治疗后及出院当天,患儿最高体温逐渐减低,PaO_(2)/FiO_(2)逐渐增加;LUS评分逐渐减低,较显著肺实变范围逐渐缩小(P均<0.05)。治疗前LUS评分与PaO_(2)/FiO_(2)呈负相关(r_(s)=-0.5607,P=0.0013);治疗后LUS评分降低程度与PaO_(2)/FiO_(2)增加程度呈正相关(r_(s)=0.4803,P=0.0072)。结论LUS可动态观察并评估BAL治疗感染性肺炎效果。

Objective To explore the value of lung ultrasonography(LUS)for dynamic assessment of therapeutic effect of bronchoalveolar lavage(BAL)in children with infectious pneumonia.Methods Thirty children with infectious pneumonia treated with BAL were enrolled.LUS was performed before treatment,2-6 days after treatment and on the day of discharge,respectively.Lung ultrasonography was observed and LUS score was assessed,the maximum body temperature and oxygenation index(PaO_(2)/FiO_(2))were measured,and the correlation between LUS score and PaO_(2)/FiO_(2)was analyzed.Results The maximum body temperature gradually decreased after treatment and on the day of discharge,PaO_(2)/FiO_(2)gradually increased,LUS score gradually decreased,and the range of significant lung consolidation gradually narrowed(all P<0.05).Before treatment,there was a significant negative correlation between LUS score and PaO_(2)/FiO_(2)(r=-0.5607,P=0.0013).After treatment,the reduction of LUS score was positively correlated with the increase of PaO_(2)/FiO_(2)(r=0.4803,P=0.0072).Conclusion LUS could dynamically observe and evaluate the therapeutic effect of BAL for treatment of children with infectious pneumonia.