做肺部超声波和x光胸腔诊断早期和新生儿需要呼吸

M. Jorczyk
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引用次数: 0

摘要

肺超声(LUS)已成为新生儿护理点超声(POCUS)中最令人兴奋的应用之一,但仍缺乏常规临床应用。本研究评估了LUS在新生儿呼吸系统疾病(nrd)诊断和随访中的应用,并与胸片(CXR)进行了比较。对100例胎龄≥28周的nrd新生儿进行了前瞻性横断面研究,排除了多发性先天性异常、染色体畸变、胎儿水肿和/或心力衰竭的新生儿。在入院诊断时进行CXR和LUS,并在7天后重复进行,如果需要,也可在7天内更早进行。入院时和入院后7天CXR和LUS对NRDs的诊断具有可比性(p > 0.05)。LUS诊断呼吸窘迫综合征、肺炎、胎粪吸入综合征、气胸和肺不张的敏感性和特异性分别为94.7/100%、97.5/95%、92.3/100%、90.9/98.9%和100/97.8%。LUS和CXR之间的总一致性为98.5%,95% CI(0.88 ~ 0.92)。LUS和CXR对NRDs的诊断有相当大的一致性。作为一种可靠的床边诊断方式,LUS比CXR更安全,可以被认为是诊断新生儿NRDs的一种替代方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lungenultraschall vs. Röntgen-Thorax – ebenbürtige Diagnostik für Früh- und Neugeborene mit Atemnot?
Lung ultrasound (LUS) has become one of the most exciting applications in neonatal point of-care ultrasound (POCUS), yet still lacks routine clinical use. This study assesses the utility of LUS for neonatal respiratory disorders (NRDs) diagnosis and follow-up compared to chest X-ray (CXR). A prospective cross-sectional study was conducted on 100 neonates having NRDs with a gestational age ≥28 weeks, excluding those having multiple congenital anomalies, chromosomal aberrations, hydrops fetalis and/or heart failure. CXR and LUS were done on admission for diagnosis and were repeated after 7 days, or if needed earlier within the 7 days. The diagnosis of NRDs by CXR and LUS on admission and after 7 days was comparable (p > 0.05). LUS diagnosis sensitivity and specificity for respiratory distress syndrome, pneumonia, meconium aspiration syndrome, pneumothorax and pulmonary atelectasis were 94.7/100%, 97.5/95%, 92.3/100%, 90.9/98.9% and 100/97.8%, respectively. The total agreement between LUS and CXR was 98.5% with 95% CI (0.88 to 0.92). LUS and CXR had considerable agreement in the diagnosis of NRDs. Being a reliable bedside modality of diagnosis and safer than CXR, LUS may be considered an alternative method for the diagnosis of neonates with NRDs.
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