不对称肺部超声征象在儿童重症肺炎诊断中的价值

Value of asymmetric pulmonary ultrasound signs in the diagnosis of severe pneumonia in children

目的探讨不对称肺部超声征象在儿童重症肺炎诊断中的价值。方法回顾性分析2018年7月至2020年6月在广东医科大学附属医院儿童医学中心PICU住院治疗的54例重症肺炎患儿的一般基线资料和肺超声等影像学资料,重点分析重症肺炎患儿出现的不对称性肺部超声征象。结果54例患儿中男性36例,女性18例,男女比例为2:1;年龄中位数为24(6,42)个月;起病时间(3±0.5)d;机械通气32例,普通吸氧22例。在54例重症肺炎患儿中,出现不对称肺部超声征象时临床诊断单侧肺实变14例(占35.9%),单侧气胸12例(占22.2%),单侧胸腔积液10例(占18.6%),单侧肺不张8例(占14.8%),塑性支气管炎/支气管异物6例(占11.1%),气管插管过深4例(占7.4%)。结论在儿童重症肺炎患儿中出现不对称肺部超声征象常提示存在肺部急症,其类型可协助临床进行肺部急症病因的鉴别诊断。

Objective To explore the value of asymmetric pulmonary ultrasound signs in the diagnosis of severe pneumonia in children.Methods The general baseline data and imaging data(such as lung ultrasound)of 54 children with severe pneumonia who were hospitalized in the PICU of the Children's Medical Center,the Affiliated Hospital of Guangdong Medical University from July 2018 to June 2020 were retrospectively analyzed.Asymmetric pulmonary ultrasound signs in children with severe pneumonia.Results Among the 54 children,there were 36 males and 18 females,with the male-to-female ratio of 2:1,the median age of 24(6,42)months,the time of onset of(3±0.5)days.There were 32 cases of mechanical ventilation and 22 cases of ordinary oxygen inhalation.Among the 54 children were analyzed,there were 14 cases of unilateral lung consolidation(35.9%),12 cases of unilateral pneumothorax(22.2%),10 cases of unilateral pleural effusion(18.6%),8 cases of unilateral atelectasis(14.8%),6 cases of plastic bronchitis/bronchial foreign body(11.1%),and 4 cases of deep endotracheal intubation(7.4%).Conclusion The appearance of asymmetric pulmonary ultrasound signs in children with severe pneumonia often indicates the existence of pulmonary emergency,and the types of the signs can assist in the differential diagnosis of pulmonary emergency.