床边肺部超声对新生儿肺不张的诊断价值

Diagnostic value of bedside lung ultrasound in neonatal atelectasis

目的探讨床边肺部超声对新生儿肺不张的诊断价值。方法选取2021年1月至2022年12月赣州市妇幼保健院收治的68例疑似肺不张新生儿作为研究对象,采用床边肺部超声、X线检查,临床资料完整。比较床边肺部超声、X线检查诊断准确率,治疗期间患儿恢复情况。结果68例疑似新生儿肺不张诊断胸部CT检测结果为金标准,确诊66例阳性新生儿肺不张,2例阴性,其中局灶性肺不张50例,隐匿性肺不张16例。床边肺部超声诊断新生儿肺不张,阳性共65例,阴性3例,灵敏度100.00%(65/65),特异度66.67%(2/3),准确度98.53%(67/68);X线检查,阳性60例,阴性8例,灵敏度98.33%(59/60),特异度12.50%(1/8),准确度88.24%(60/68)。两种方法灵敏度比较,差异无统计学意义(χ^(2)=0.002,P=0.968),床边肺部超声的准确度高于X线(χ^(2)=4.284,P=0.038),两种方法特异度比较,差异无统计学意义(χ^(2)=1.074,P=0.300)。66例新生儿肺不张阳性患儿出院前治疗效果痊愈54例,好转10例,其他2例,床边肺部超声和X线片检查结果的符合率比较差异无统计学意义(χ^(2)=0.173,P=0.678)。结论床边肺部超声用于新生儿肺不张诊断准确性较高,能更准确检测出隐匿性肺不张,且可减少新生儿暴露在X光照射下,具有较高的安全性。

Objective Explore the diagnostic value of bedside lung ultrasound in neonatal atelectasis.Methods A total of 68 newborns with suspected atelectasis admitted to Ganzhou Maternal and Child Health Hospital from January 2021 to December 2022 were selected as research objects and underwent bedside lung ultrasound and X-ray examination,with complete clinical data.The diagnostic accuracy of bedside lung ultrasound and X-ray examination,as well as the recovery of the child during treatment were compared.Results A total of 68 suspected cases of neonatal atelectasis were diagnosed with chest CT examination results that met the gold standard.A total of 66 positive cases of neonatal atelectasis were confirmed,and 2 were negative.Among them,50 were focal atelectasis and 16 were occult atelectasis.The bedside lung ultrasound diagnosis of neonatal atelectasis was positive in 65 cases,negative in 3 cases,with sensitivity of 100.00%(65/65),specificity of 66.67%(2/3),and accuracy of 98.53%(67/68).X-ray examination showed positive results in 60 cases and negative results in 8 cases,with sensitivity of 98.33%(59/60),specificity of 12.50%(1/8),and accuracy of 88.24%(60/68).There was no statistically significant difference in sensitivity between the two methods(χ^(2)=0.002,P=0.968).The accuracy of bedside lung ultrasound was higher than that of X-ray(χ^(2)=4.284,P=0.038),and there was no statistically significant difference in specificity(χ^(2)=1.074,P=0.300).Before discharge,the treatment effect of 66 positive cases of neonatal atelectasis was cured in 54 cases,improved in 10 cases,and the other 2 cases.There was no statistically significant difference in the coincidence rate between bedside lung ultrasound and X-ray examination results(χ^(2)=0.173,P=0.678).Conclusion The bedside lung ultrasound used in the diagnosis of neonatal atelectasis has a high accuracy,can more accurately detect hidden atelectasis,and can reduce the exposure of newborns to X-ray irradiation,and has high safety.