重症肺炎患儿肺部超声检查表现与临床治疗效果的关系

Relationship between ultrasonographic findings of lungs and clinical treatment effect in children with severe pneumonia

目的 探讨重症肺炎患儿肺部超声检查表现及与患儿临床治疗效果的关系。方法 选取我院收治的重症肺炎患儿80例(重症组),另选取同期治疗的普通肺炎患儿80例(对照组),两组患儿均进行肺部超声检查,对比重症及非重症患儿肺部超声检查表现差异,观察重症组患儿治疗前后肺部超声检查表现变化,并根据疗效分组,对比治疗有效组与治疗无效组肺部超声检查表现差异,完成影响此类患儿临床疗效的Logistic回归分析。结果 重症组B线≥10条、胸腔积液、支气管充气征、胸膜异常征、肺实变征患儿占比显著高于对照组,差异有统计学意义(P<0.05);治疗后重症组患儿B线≥10条、胸腔积液、气管充气征、胸膜异常征、肺实变征占比明显低于治疗前,差异有统计学意义(P<0.05);治疗有效组B线≥10条、胸腔积液、支气管充气征、胸膜异常征、肺实变征患儿占比显著低于治疗无效组,差异有统计学意义(P<0.05);Logistic回归分析证实,B线≥10条、胸腔积液、气管充气征、胸膜异常征、肺实变征均为重症肺炎患儿治疗无效的独立危险因素(均OR>1,P<0.05)。结论 肺部超声检查可用于重症肺炎患儿的诊断鉴别,且通过治疗过程中肺部超声检查表现的变化进行疗效评估。

Objective To explore the relationship between the ultrasonographic findings of the lungs in children with severe pneumonia and the clinical treatment effect of the children.Methods 80 children with severe pneumonia admitted to our hospi⁃tal(severe group)were selected,and another 80 children with common pneumonia treated at the same time(control group)were selected.Both groups of children underwent lung ultrasonography.We compared severe and non-severe cases,observed the dif⁃ferences in lung ultrasound examination performance of children in the critically ill group before and after treatment,grouped them according to the curative effect,compared the differences in lung ultrasound examination performance between the treat⁃ment effective group and the treatment ineffective group,and completed the impact on the clinical efficacy of such children by Logistic regression analysis.Results The proportion of children with B lines≥10,pleural effusion,air bronchus sign,pleural abnormality,and pulmonary consolidation in the severe group was significantly higher than that in the control group(P<0.05);after treatment,the children in the severe group had B lines≥10 Lines,pleural effusion,tracheal air sign,pleural abnormality,and pulmonary consolidation were significantly lower than those before treatment(P<0.05);in the effective treatment group,there were more than 10 B lines,pleural effusion,bronchial air sign,and pleural abnormality were significantly lower than the treatment-ineffective group(P<0.05);Logistic regression analysis confirmed that B-line≥10,pleural effusion,tracheal infla⁃tion,pleural abnormality,and pulmonary consolidation were an independent risk factors for treatment failure in children with se⁃vere pneumonia(all OR>1,P<0.05).Conclusion Lung ultrasonography can be used in the diagnosis and differentiation of children with severe pneumonia,and the efficacy can be evaluated by the changes of lung ultrasonography during treatment.