肺部超声指导下的体位管理在新生儿感染性肺炎治疗中的应用

Application of positional management guided by lung ultrasonography in the treatment of neonatal infectious pneumonia

目的探讨采用肺部超声(LUS)十二分区法指导下的体位管理在新生儿感染性肺炎治疗中的临床应用价值。方法选取76例胎龄>36周且纠正胎龄<44周、临床诊断为新生儿感染性肺炎的患儿为研究对象,将其随机分为LUS指导下的体位管理组(治疗组)和常规体位管理组(对照组)。比较2组患儿干预前、干预后第3日、第7日的LUS变化情况(以LUS十二分区法评分评估)以及氧疗时间、住院时间等。结果2组患儿在干预前背部和肺部LUS评分高于前胸和侧胸评分(P均<0.05)。干预后第7日,治疗组的背部LUS评分低于对照组(P<0.05),但背部LUS评分高于前胸及侧胸,侧胸LUS评分高于前胸(P均<0.001)。治疗组干预后第7日的LUS总评分低于对照组(P<0.05),并且低于干预前及干预第3日的LUS总评分(P均<0.001)。治疗组的住院时间短于对照组(P<0.05)。结论LUS十二分区法指导下的体位管理有利于促进新生儿感染性肺炎的恢复,缩短住院时间。

Objective To evaluate the clinical application value of positional management guided by 12-zone lung ultrasound(LUS)in the treatment of neonatal infectious pneumonia.Methods A total of 76 neonates with a gestational age of>36 weeks and corrected gestational age of<44 weeks,clinically diagnosed with neonatal infectious pneumonia,were selected as the study subjects.They were randomly divided into the LUS-guided positional management group(treatment group)and conventional positional management group(control group).Compare the changes in LUS(assessed by LUS 12-zone score)before the intervention and on the 3rd and 7th days after the intervention,as well as the duration of oxygen therapy and hospital stay,between the two groups of children.Results Prior to intervention,the LUS scores in both groups were significantly higher than those of the anterior and lateral chest(all P<0.05).On 7th day after the intervention,the LUS scores of dorsal in the treatment group were significantly lower than those in the control group(P<0.05),and in both groups,the LUS scores of dorsal remained significantly higher than those of the anterior and lateral chest(all P<0.001).Additionally,the LUS scores of chest were significantly higher than those of the anterior chest(P<0.001).The total LUS score on 7th day after the intervention in the treatment group were significantly lower than that in the control group(P<0.05),and compared to pre-intervention and the 3rd day after the intervention,the total LUS score in the treatment group showed a significant decrease(both P<0.001).The length of hospital stay in the treatment group was significantly shorter than that in the control group(P<0.05).Conclusion Positional management guided by 12-zone LUS is beneficial in promoting the recovery from neonatal infectious pneumonia and shortening the length of hospital stay.