肺部超声与X线胸片在NRDS诊断中的优劣差异
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摘要
目的:探讨研究肺部超声与X线在新生儿呼吸窘迫综合症(NRDS)中的诊断价值优劣性差异。方法:随机抽取2016年2018年来我院就诊54例存在呼吸窘迫症状的新生儿作为研究对象。将每名患儿先后采用X线检查与肺部超声检查,对比两种检查方法准确性,包括特异度、灵敏度等。结果:54例患儿中,以临床诊断为金标准最终诊断为NRDS患儿43例,诊断为新生儿肺炎为8例,胎儿先天性膈疝1例,其他2例。根据X线检查结果诊断出NRDS为37例,其中真阳性患儿34例,假阳性患儿3例,真阴性患儿9例,假阴性患儿8例。根据肺部超声检查结果诊断出NRDS为40例,其中真阳性患儿37例,假阳性患儿3例,真阴性患儿10例,假阴性患儿4例。肺部超声诊断与临床诊断符合率、特异度、灵敏度、阴性预测率均显著高于X线检查,差异具有统计学意义(P<0.05),两种检查方法对于诊断NRDS的阳性预测率对比差异无统计学意义(P>0.05)。结论:肺部超声检查比X线胸片检查在NRDS诊断中具有更高准确性和安全性,值得临床推广。
Objective:To investigate the difference of diagnostic value between pulmonary ultrasound and X-ray in neonatal respiratory distress syndrome(NRDS).Methods:54 newborns with respiratory distress symptoms were randomly selected from our hospital in 2016 and 2018. Each child was examined by X-ray and pulmonary ultrasonography, and the accuracy of the two methods was compared, including specificity and sensitivity.Results:Of 54 cases, 43 cases were diagnosed as NRDS, 8 cases as neonatal pneumonia, 1 case as fetal congenital diaphragmatic hernia and 2 cases as the gold standard. According to the results of X-ray examination, 37 cases of NRDS were diagnosed, including 34 cases of true positive children, 3 cases of false positive children, 9 cases of true negative children and 8 cases of false negative children. According to the results of pulmonary ultrasonography, 40 cases of NRDS were diagnosed, including 37 true-positive children, 3 false-positive children, 10 true-negative children and 4 false-negative children. The coincidence rate, specificity, sensitivity and negative predictive rate of pulmonary ultrasound diagnosis and clinical diagnosis were significantly higher than those of X-ray examination(P < 0.05). There was no significant difference in the positive predictive rate of diagnosis of NRDS between the two methods(P > 0.05).Conclusion:Pulmonary ultrasonography is more accurate and safe than X-ray chest radiography in the diagnosis of NRDS, which is worthy of clinical promotion.
Objective:To investigate the difference of diagnostic value between pulmonary ultrasound and X-ray in neonatal respiratory distress syndrome(NRDS).Methods:54 newborns with respiratory distress symptoms were randomly selected from our hospital in 2016 and 2018. Each child was examined by X-ray and pulmonary ultrasonography, and the accuracy of the two methods was compared, including specificity and sensitivity.Results:Of 54 cases, 43 cases were diagnosed as NRDS, 8 cases as neonatal pneumonia, 1 case as fetal congenital diaphragmatic hernia and 2 cases as the gold standard. According to the results of X-ray examination, 37 cases of NRDS were diagnosed, including 34 cases of true positive children, 3 cases of false positive children, 9 cases of true negative children and 8 cases of false negative children. According to the results of pulmonary ultrasonography, 40 cases of NRDS were diagnosed, including 37 true-positive children, 3 false-positive children, 10 true-negative children and 4 false-negative children. The coincidence rate, specificity, sensitivity and negative predictive rate of pulmonary ultrasound diagnosis and clinical diagnosis were significantly higher than those of X-ray examination(P < 0.05). There was no significant difference in the positive predictive rate of diagnosis of NRDS between the two methods(P > 0.05).Conclusion:Pulmonary ultrasonography is more accurate and safe than X-ray chest radiography in the diagnosis of NRDS, which is worthy of clinical promotion.
引文
1 尹旭,王倩.肺部超声与X线在新生儿呼吸窘迫综合征中的诊断价值对比研究[J].检验医学与临床,2018,15(08):1077-1079.
2 王小华,黎见,蒋国美,何立红,等.床旁肺脏超声评估新生儿肺透明膜病严重程度[J].医学影像学杂志,2017,27(03):458-460+468.
3 姚一明,彭华保,曾平,等.肺脏超声在新生儿呼吸窘迫综合征诊治中应用探讨[J].中国临床医生杂志,2017,45(03):103-105.
4 张丹.肺超声检查的应用与进展[J].中华医学超声杂志(电子版),2018,15(07):486-489.
5 吴任贤,欧阳培元,邓文杰.床旁肺部超声在危重新生儿监护治疗中的应用[J].中国现代药物应用,2018,12(03):6-8.
6 姜卫波,江艳丽,吴茹霞.超声在新生儿肺部疾病诊断中的应用[J].中国中西医结合影像学杂志,2017,15(06):745-746.
7 林洲,夏焙.儿童肺部超声检查的临床应用[J].中华诊断学电子杂志,2018,6(02):92-94.
8 樊伟,高虹,李雪娇,等.超声在肺部疾病诊断中的应用[J].中华临床医师杂志(电子版),2016,10(19):2954-2957.
9 肖甜甜,金梅,巨容,等.床旁肺部超声在新生儿肺炎中的诊断价值[J].中国当代儿科杂志,2018,20(06):444-448.
2 王小华,黎见,蒋国美,何立红,等.床旁肺脏超声评估新生儿肺透明膜病严重程度[J].医学影像学杂志,2017,27(03):458-460+468.
3 姚一明,彭华保,曾平,等.肺脏超声在新生儿呼吸窘迫综合征诊治中应用探讨[J].中国临床医生杂志,2017,45(03):103-105.
4 张丹.肺超声检查的应用与进展[J].中华医学超声杂志(电子版),2018,15(07):486-489.
5 吴任贤,欧阳培元,邓文杰.床旁肺部超声在危重新生儿监护治疗中的应用[J].中国现代药物应用,2018,12(03):6-8.
6 姜卫波,江艳丽,吴茹霞.超声在新生儿肺部疾病诊断中的应用[J].中国中西医结合影像学杂志,2017,15(06):745-746.
7 林洲,夏焙.儿童肺部超声检查的临床应用[J].中华诊断学电子杂志,2018,6(02):92-94.
8 樊伟,高虹,李雪娇,等.超声在肺部疾病诊断中的应用[J].中华临床医师杂志(电子版),2016,10(19):2954-2957.
9 肖甜甜,金梅,巨容,等.床旁肺部超声在新生儿肺炎中的诊断价值[J].中国当代儿科杂志,2018,20(06):444-448.