摘要
目的 探讨儿童社区获得性肺炎（CAP）的肺部超声影像学特点，并分析其在儿童CAP中的诊断价值。方法 选取我院呼吸科经X线胸片确诊的CAP患儿173例（CAP组），另选同期门诊64例健康儿童行肺部超声检查作为对照组，比较两组声像图特征。结果 CAP组肺部超声声像图表现为A-线消失（100%），B-线存在（88.4%）、胸膜线异常（98.3%）、肺实变（46.2%）、支气管征（42.8%）、胸腔积液（9.2%）、肺滑动征（97.7%）等征象。而在对照组除可见A-线，散在B-线（34.4%）外，其他均不存在，两组肺部超声声像图特征比较差异均有统计学意义（P〈0.001）。出现A-线消失，B-线（甚至融合）、胸膜线异常是儿童CAP的主要超声征象，敏感性和特异性可达到100%；X线胸片的敏感性为100%，特异性为78.0%。结论 儿童CAP的超声影像学特点有A-线消失、出现数量和长度不同B-线、胸膜线异常、肺实变、支气管征、胸腔积液等。肺部超声波诊断CAP准确可靠，敏感性高、特异性强，且具有简便、无创、可随时检测、可避免X射线损伤等优点，值得儿科临床推广应用。
Objective To investigate the lung ultrasonography characteristics of community acquired pneumonia （CAP） in children and to compare the value of lung ultrasonography in the diagnosis of CAP in children. Methods A total of 173 patients with CAP （ CAP group） were diagnosed by chest radiograph in our hospital, and 64 healthy children were treated with lung ultrasonography as the control group. The sono- graphic features of two groups were compared, and the positive rates of diagnosis of lung ultrasonography and chest radiograph in CAP group were also compared. Results It showed A-line disappearance （ 100% ）, B- line presence （ 88.4% ）, pleural line abnormalities （ 98.3% ）, pulmonary consolidation （ 46. 2% ）, bronchial sign（42. 8% ） ,pleural effusion（9.2% ） ,lung sliding signs（97.7% ） in CAP group （P 〈0. 001）. In the con- trol group, except the A-line disappearance, scattered in the B-line （34. 4% ）, the others were not present. The difference of the two groups was statistically significant （ P 〈 0. 001 ）. A-line disappearance, B-line （ or even fusion） ,pleural line abnormalities were the main signs of ultrasound in children with CAP, sensitivity and specificity were both 100%. The sensitivity of chest X radiograph was 100% and the specificity was 78.0%. Conclusion The lung ultrasonic imaging features of CAP in children include A-line disappearance, with varying numbers and lengths of B-line, pleural line abnormalities, consolidation, bronchial signs, pleural effusion and so on. LUS can diagnose CAP accurately and reliably, with high sensitivity and specificity. It is simple and noninvasive, and has the advantage of being detected at any time and avoiding the damage of X-ray. So it is worth clinical application for children with respiratory tract diseases.
作者
鲁正荣
王莉
金梅
赖华
樊映红
夏万敏
吴英
杨胜
艾涛
黎桂菊
Lu Zhengrong Wang Li Jin Mei Lai Hua Fan Yinghong Xia Wanmin Wu Ying Yang Sheng Ai Tao Li Guiju(Chengdu Women＇s and Children＇s Central Hospital, Chengdu 610091, China)
出处
《中国小儿急救医学》
CAS
2017年第9期680-685,共6页
Chinese Pediatric Emergency Medicine
基金
成都市卫生局重大基金课题（2013004）
关键词
肺部超声
社区获得性肺炎
儿童
Lung ultrasound
Community-acquired pneumonia
Children
