摘要
目的探讨心肺联合超声在低氧血症新生儿病因诊断、病情监测及预后判断中的价值。方法选取2018年1月至2018年8月杭州市第一人民医院新生儿科收治的低氧血症新生儿45例为实验组,选取同期住院的非低氧血症新生儿20例作为对照组。所有患儿均进行超声心动图联合肺部超声检查。应用超声心动图诊断结构性疾病并评估心功能,同时使用肺部超声评分法评估肺部情况,对超声检查结果及临床病因诊断结果进行综合分析。结果 45例低氧血症患儿临床病因有多种,包括呼吸窘迫综合征、先天性心脏病、胎粪吸入综合征、暂时性呼吸增快症、窒息后复苏等。45例低氧血症患儿中,超声心动图提示左心功能下降8例,右心功能下降1例,肺动脉高压33例;肺部超声表现为不同程度B线增多,肺局部实性变,双侧肺部评分0~30分,以13~24分者居多,单侧肺部最高评分18分。20例对照组新生儿超声心动图及肺部超声表现均未见明显异常。45例低氧血症患儿中,8例左心功能下降的患儿肺部均出现了弥漫性肺泡-间质综合征,1例右心功能下降患儿,肺部超声表现为以A线为主,单侧肺部评分2分。结论心肺联合超声可为低氧血症新生儿的临床病因诊断提供线索和依据,对疾病进展进行监测及预判,且具有无辐射、方便快捷、费用低廉等优势,值得临床推广应用。
Objective To explore the value of integrated cardiopulmonary ultrasound in etiological diagnosis, disease monitoring, and prognosis evluation of neonates with hypoxemia. Methods Forty-five neonates with hypoxemia admitted to the Department of Neonatology, Hangzhou First People’s Hospital,Zhejiang University Medical College from January to August 2018 were selected as a study group, and 20 non-hypoxic neonates who were hospitalized during the same period were selected as a control group. All the neonates underwent integrated cardiopulmonary ultrasonic examination. Echocardiography was used to diagnose structural diseases and to assess cardiac function. Pulmonary ultrasound was used to assess the condition of the lungs. The results of ultrasonography and clinical etiology were comprehensively analyzed.Results Of the 45 neonates with hypoxemia, the clinical causes included respiratory distress syndrome,congenital heart disease, meconium aspiration syndrome, temporary respiratory increase, post-asphyxia resuscitation and so on. In these neonates, echocardiography showed left heart failure in 8 cases, right heart failure in 1, and pulmonary hypertension in 33. Pulmonary ultrasound showed varying degrees of increased B-lines and local pulmonary consolidation. The total scores of bilateral lungs ranged from 0 to 30, with the most common scores ranging from 13 to 24, and the maximum score of unilateral lung was 18. There were no significant abnormalities of echocardiography or pulmonary ultrasound in the 20 neonates of the control group. In the study group, eight patients with decreased left ventricular function developed diffuse alveolarinterstitial syndrome in the lungs, and one case with decreased right heart function showed A-lines, with a unilateral lung score of 2. Conclusion Integrated cardiopulmonary ultrasound can provide clues and evidence for clinical etiology diagnosis, and monitor and predict disease progression with the advantages of no radiation, convenienience, and low cost.
作者
赵敏
包凌云
吴漪皓
黄先玫
李晓霞
芦惠
蒋春明
Zhao Min;Bao Lingyun;Wu Yihao;Huang Xianmei;Li Xiaoxia;Lu Hui;Jiang Chunming(Department of Ultrasound, Hangzhou First People's Hospital, Zhejiang University Medical College, Hangzhou 310006, China;Department of Cardiology, Hangzhou First People's Hospital, Zhejiang University Medical College, Hangzhou 310006, China;Department of Neonatology, Hangzhou First People's Hospital, Zhejiang University Medical College, Hangzhou 310006, China;Department of Ultrasound, Hangzhou Geriatric Hospital, Hangzhou 310022, China)
出处
《中华医学超声杂志（电子版）》
CSCD
北大核心
2019年第2期102-107,共6页
Chinese Journal of Medical Ultrasound(Electronic Edition)
