床旁肺脏超声在重症肺炎新生儿中的应用效果

Application of bedside lung ultrasound in newborns with severe pneumonia

摘要:

目的 探讨床旁肺脏超声在重症肺炎新生儿中的应用效果。方法 选取2023年1月—2024年1月西北妇女儿童医院收治的153例重症肺炎新生儿为研究对象，采用随机数字表法将其分为超声组（76例）和对照组（77例）。对照组接受常规肺部评估方法，超声组使用床旁肺脏超声进行肺部评估，并给予相应的肺部物理治疗。比较两组临床症状缓解时间、生命体征指标、呼吸机撤离时间、停氧时间及住院时间。结果 两组虫蚀样率、累计≥2个肋间率、支气管充液征率、胸腔积液率和肺不张率比较，差异均无统计学意义（P >0.05）。超声组咳嗽咳痰、肺部啰音、少吃少动、腹胀、心衰和休克症状缓解时间均短于对照组（P <0.05）。超声组治疗前与治疗12 h后动脉二氧化碳分压和动脉氧分压/吸入氧浓度的差值均大于对照组（P <0.05）。超声组呼吸机撤离时间、停氧时间、住院时间均短于对照组（P <0.05）。结论 床旁肺脏超声可有效评估重症肺炎新生儿肺部情况，指导治疗，促进症状缓解和肺功能恢复，缩短住院周期，具有良好的临床应用价值。

Abstract:

Objective To explore the efficacy of bedside lung ultrasound in newborns with severe pneumonia.Method A total of 153 newborns with severe pneumonia admitted to Northwest Women's and Children's Hospital from January 2023 to January 2024 were selected. They were randomly assigned into the ultrasound group (n = 76) and the control group (n = 77) using a random number table method. The control group received conventional pulmonary assessment methods, while the ultrasound group underwent bedside lung ultrasound for pulmonary evaluation and received corresponding pulmonary physiotherapy. The two groups were compared in terms of the time to clinical symptom relief, vital signs, duration of mechanical ventilation, oxygen therapy duration, and length of hospital stay.Results There were no statistically significant differences between the ultrasound group and the control group regarding the rate of shred sign, incidence of involvement of two or more intercostal spaces, rate of fluid bronchogram sign, pleural effusion rate, and atelectasis rate (P > 0.05). However, the symptom relief times for cough and expectoration, pulmonary rales, reduced appetite and activity, abdominal distension, heart failure, and shock were significantly shorter in the ultrasound group compared to the control group (P < 0.05). The differences of the arterial partial pressure of carbon dioxide and the ratio of partial pressure arterial oxygen and fraction of inspired oxygen before treatment and 12 hours after treatment were significantly greater in the ultrasound group than in the control group (P < 0.05). Furthermore, the ultrasound group had significantly shorter durations of mechanical ventilation and oxygen therapy, as well as length of hospital stay compared to the control group (P < 0.05).Conclusion Bedside lung ultrasound can effectively assess pulmonary status in neonates with severe pneumonia, guide treatment, promote symptom relief and lung function recovery, shorten the length of hospital stay, and demonstrates significant clinical value.