肺部超声评分联合肺潮气功能检测在小儿重症肺炎诊断中的应用价值

Application value of lung ultrasound score combined with lung tidal function test in the diagnosis of severe pneumonia in children

目的分析肺部超声评分(LUS)联合肺潮气功能检测在小儿重症肺炎诊断中的应用价值。方法将2019年1月至2021年10月在本院接受诊治的237例肺炎患儿作为观察组,选取同期健康体检的50名正常儿童作为对照组;依据病情严重程度将观察组分为轻症组(158例)和重症组(79例)。比较各组的LUS评分和达峰容积比(VPTEF/VE)、达峰时间比(TPTEF/TE)。结果恢复期,观察组的VPTEF/VE、TPTEF/TE高于急性期(P<0.01);急性期和恢复期,观察组的VPTEF/VE、TPTEF/TE低于对照组(P<0.01)。急性期,重症组的LUS评分明显高于轻症组,VPTEF/VE、TPTEF/TE低于轻症组和对照组(P<0.01);恢复期,轻症组和重症组的LUS评分低于急性期,VPTEF/VE、TPTEF/TE高于急性期(P<0.01);恢复期,重症组的LUS评分高于轻症组,VPTEF/VE、TPTEF/TE低于轻症组和对照组(P<0.01)。受试者工作特征(ROC)曲线分析显示,LUS评分和VPTEF/VE、TPTEF/TE在诊断小儿重症肺炎方面均具有一定价值,LUS评分、VPTEF/VE和TPTEF/TE联合测定诊断小儿重症肺炎的效能显著优于三项指标单独测定(P<0.05)。结论LUS评分和VPTEF/VE、TPTEF/TE均与肺炎患儿病变程度显著相关,三者联合测定在评估重症肺炎方面具有良好价值。

Objective To analyze the application value of lung ultrasound score(LUS)combined with lung tidal function test in the diagnosis of severe pneumonia in children.Methods Two hundred and thirty-seven children with pneumonia who were diagnosed and treated in our hospital from January 2019 to October 2021 were selected as observation group,and 50 normal children who underwent physical examination during the same period were selected as control group;according to the severity of the disease,the observation group was divided into mild group(158 cases)and severe group(79 cases).The LUS score,ratio of volume at peak tidal expiratory flow to expiratory tidal volume(VPTEF/VE)and ratio of time to peak tidal expiratory flow to total expiratory time(TPTEF/TE)were compared among the groups.Results In the recovery period,the VPTEF/VE and TPTEF/TE in the observation group were higher than those in the acute period(P<0.01);in the acute and recovery period,the VPTEF/VE and TPTEF/TE in the observation group were lower than those in the control group(P<0.01).In the acute period,the LUS score of the severe group was significantly higher than that of the mild group,the VPTEF/VE and TPTEF/TE were lower than those of the mild group and the control group(P<0.01);in the recovery period,the LUS score of the mild group and the severe group were lower than those in the acute period,the VPTEF/VE and TPTEF/TE were higher than those in the acute period(P<0.01);in the recovery period,the LUS score of the severe group was higher than that of the mild group,the VPTEF/VE and TPTEF/TE were lower than those of the mild group and the control group(P<0.01).Receiver operating characteristic(ROC)curve analysis showed that LUS score,VPTEF/VE and TPTEF/TE had certain value in the diagnosis of severe pneumonia in children,the efficacy of LUS score,VPTEF/VE and TPTEF/TE combined determination in the diagnosis of severe pneumonia in children was significantly better than that of the three indicators alone(P<0.05).Conclusion LUS score,VPTEF/VE and TPTEF/TE were significantly correlated with the severity of pneumonia in children,the combined determination of the three has good value in evaluating severe pneumonia.