摘要
目的探讨肺超声评分对评估新生儿感染性肺炎(nfectious pneumonia,IPN)病情严重程度的临床价值。方法选取2017年7月-2019年7月在郑州大学附属郑州市中心医院新生儿重症监护病房确诊的IPN患儿150例,根据有无呼吸衰竭分为无呼吸衰竭组(62例)和呼吸衰竭组(88例),根据新生儿危重症评分(neonatalcritical ilness score,NCIS)将呼吸衰竭组患儿分为非危重组(26例)、危重组(33例)和极危重组(29例)。对患儿行肺超声检查并统计肺超声评分,比较各组间和组内肺超声评分、氧合指数(oxygenationindex,OI)、呼吸指数(respiratory index,RI)及NCIS评分,并分析肺超声评分与NCIS评分.0I、RI之间的相关性。结果呼吸衰竭组患儿肺超声评分和0I指标明显低于无呼吸衰竭组(均P<0.05),RI指标明显高于无呼吸衰竭组(P<0.05);在呼吸衰竭组患儿中,随病情程度加重,其肺超声评分、NCIS评分,01指标明显下降,RI指标明显升高(均P<0.05);经ROC曲线分析,IPN患儿呼吸衰竭时其肺超声评分最佳预测值为31分,灵敏度和特异度分别为85.8%.76.9%,病情危重的最佳预测值为27分,灵敏度和特异度分别为86.3%、85.7%,病情极危重的最佳预测值为17分,灵敏度和特异度分别为76.9%91.8%;经Pearson分析显示,呼吸衰竭患儿肺超声评分与NCIS评分.0I指标呈正相关(均P<0.05),与RI指标呈负相关(P<0.05)。结论肺超声评分可有效评估新生儿IPN的病情严重程度,为临床医生了解患儿的病情严重程度和合理治疗提供参考依据,具有较高的临床应用价值。
Objective To evaluate the elinical value of pulmonary ultrasound score in evaluating the severity of neonatal infectious pneumonia(IPN).Methods From July 2017 to July 2019,150 cases of children with IPN confirmed in our hospital neonatal intensive care unit were selected.According to the presence of respiratory failure,they were divided into no respiratory failure group(62 cases)and respiratory failure group(88 cases).According to neonatal critical ilness score(NCIS),children with respiratory failure group were divided into critical group(26 cases),eritical group(33 ca-ses)and extremely critical group(29 cases).Pulmonary ultrasound examination and pulmonary ultrasound score were performed on the children,and the pulmonary ulrasound score,oxygenation index(0I),respiratory index(RI)and NCIS indexes were compared among and within the groups,and the correlation between pulmonary ultrasound score and NCIS score,0I and RI was analyzed.Results The pulmonary ultrasound score and 0I indexes in the respiratory failure group were signifcantly lower than those in the non-respiratory failure group(all P<0.01),and the RI indexes were sig-nificanly higher than those in the non-respiratory failure group(P<0.01).In the respiratory failure group,the pulmo-nary ultrasound score,NCIS score and OI index decreased significantly and RI index increased significantly with the ag-gravation of the disease(all P<0.01).According to ROC curve analysis,the optimal prediction value of pulmonary ul-trasound score in IPN children with respiratory failure was 31 points,the sensitivity and specificity were 85.8%and 76.9%,respectively.The optimal prediction value of critical condition was 27 points,the sensitivity and specificity were 86.3%and 85.7%,respectively.The optimal prediction value of extremely critical condition was 17 points,the sensi-tivity and specificity were 76.9%and 91.8%,respectively.Pearson analysis showed that the pulmonary ultrasound score of children with respiratory failure was positively correlated with NCIS score and OI index
作者
肖燕
闫媛媛
娄君鸽
XIAO Yan;YAN Yuan-yuan;LOU Jun-ge(Department of ultrasound medicine,Zhengzhou Central Hospital,Zhengzhou,Henan 450000,China)
出处
《中华全科医学》
2020年第10期1711-1714,共4页
Chinese Journal of General Practice
基金
河南省高等学校重点科研项目计划(19A320077)。
关键词
肺超声评分
新生儿
感染性肺炎
病情严重程度
Pulmonary ultrasound score
Newborn
Infectious pneumonia
Severity of illness
