摘要
目的:分析肺超声联合脐动脉血气分析指标评估早产儿合并呼吸窘迫综合征(NRDS)病情严重程度的价值。方法:选取2020年5月—2022年5月恩施土家族苗族自治州中心医院收治的82例进行X线、肺超声和脐动脉血气分析的早产儿NRDS为研究对象,根据胸片检查可将患儿分为轻度组(Ⅰ~Ⅱ级,n=52)和重度组(Ⅲ~Ⅳ级,n=30),对所有患儿进行肺超声检查,计算肺超声评分,并测定脐动脉血气分析指标[pH值、氧分压(PO_(2))、二氧化碳分压(PCO_(2))、碱剩余(BE)]。早产儿NRDS病情程度的因素用单因素和Logistic回归分析,肺超声联合脐动脉血气分析指标对患儿病情的诊断价值用受试者工作特征(ROC)曲线。结果:两组患儿性别、胎龄、出生体质量比较无明显差异(P>0.05),产妇分娩方式、新生儿窒息、患儿母亲妊娠期并发症、胎膜早破、宫内细菌感染差异显著(P<0.05);轻度组肺超声评分为(28.64±5.33)分,明显高于对照组的(23.45±4.16)分(P<0.05);重度组pH值、PO_(2)、BE明显低于轻度组(P<0.05),PCO_(2)明显高于轻度组(P<0.05);Logistics回归分析显示,新生儿窒息、胎膜早破、宫内细菌感染、肺超声评分、pH值、PO_(2)、PCO_(2)、BE是早产儿NRDS病情严重程度的危险因素(P<0.05);ROC曲线显示,肺超声和脐动脉血气分析指标联合诊断价值优于单独诊断(P<0.05)。结论:肺超声评分和脐动脉血气分析指标对评估早产儿NRDS病情严重程度有一定的价值,以其联合诊断价值最高。
Objective:To investigate pulmonary ultrasound combined with umbilical artery blood gas analysis in evaluating the severity of premature infants with respiratory distress syndrome(NRDS).Meth⁃ods:From May 2020 to May 2022,82 cases of NRDS of premature infants admitted to The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture who underwent X-ray,pulmonary ultrasound and umbilical artery blood gas analysis were selected as the study subjects.According to chest radiographs,the infants were be divided into mild group(GradeⅠ-Ⅱ,n=52)and severe group(GradeⅢ-Ⅳ,n=30).All the children were examined by pulmonary ultrasound,and their pulmonary ultrasound score was calculated,and the umbilical artery blood gas analysis indicators such as pH value,partial pressure of oxygen(PO_(2)),partial pressure of carbon dioxide(PCO_(2)),and alkali surplus(BE),were measured.The factors of the severity of NRDS in premature infants were analyzed by single factor and logistic regression,and the diagnostic value of pulmonary ultrasound combined with um-bilical artery blood gas analysis index for the condition of children was determined by the receiver operator characteristic(ROC)curve.Results:There was no significant difference in sex,gestational age and birth weight between the two groups(P>0.05).There were significant differences in maternal delivery mode,neonatal asphyxia,pregnancy complications,premature rupture of membranes,and intrauterine bacterial infection between the two groups(P<0.05);The lung ultrasound score in the mild group was(28.64±5.33),which was significantly higher than that in the control group(23.45±4.16)(P<0.05);pH value,PO_(2),and BE in severe group were significantly lower(P<0.05),and PCO_(2) was significantly higher than that respectively in mild group(P<0.05);Logistic regression analysis showed that neonatal asphyxia,premature rupture of membranes,intrauterine bacterial infection,lung ultrasound score,pH,PO_(2),PCO_(2),and BE were risk factors for the severity of NRDS in premature infants(P<0.05
作者
杨依
师体军
潘非非
梅欢欢
宋军
YANG Yi;SHI Tijun;PAN Feifei;MEI Huanhuan;SONG Jun(Dept.of Neonatology,The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,Hubei,China;Xiangyang Central Hospital Medical Laboratory,Xiangyang 441000,Hubei,China;Dept.of Pediatrics,Huadu District Maternal and Child Health Hospital,Guangzhou 510800,Guangdong,China;Dept.of Pediatrics,Yichang Central People's Hospital,Yichang 443003,Hubei,China;Dept.of Gastroenterology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)
出处
《武汉大学学报（医学版）》
CAS
2024年第11期1358-1363,共6页
Medical Journal of Wuhan University
基金
湖北省自然科学基金资助项目(编号:2021CFB401)。
关键词
肺超声检查
脐动脉血气分析指标
早产儿
呼吸窘迫综合征
病情严重程度
Pulmonary Ultrasound
Umbilical Artery Blood Gas Analysis Indicators
Premature Infant
Respiratory Distress Syndrome
Severity of Disease
