The Diagnostic Value Of Pulmonary Ultrasound In NICU For Common Pulmonary Diseases In Neonates

Objective:To investigate the clincina diagnostic value of pulmonary ultrasound in neonatal intensive care unit(NICU).Methods:(1)The clinical data of 76 patients with dyspnea admitted to the second hospital of hebei medical university from January 2018 to August 2019 were retrospectively analyzed.LUS and X-ray examinations were performed on 76 patients,with clinical diagnosis as the standard.Calculate the sensitivity and specificity of LUS and TTN in the diagnosis of RDS and TTN,respectively.To compare the diagnostic value of the two methods for these two diseases.(2)The differences of common ultrasonic manifestations and ultrasonic signs of RDS,TTN,IPN and PHN in newborn were summarized to provide a basis for clinical diagnosis.(3)The ultrasonic manifestations of 16 newbornwith RDS before and after injection of alveolar surfactant(PS)were compared to evaluate the therapeutic effect of PS.Results:The two methods were compared with the final clinical diagnosis,which included 50 cases of RDS,19 cases of TTN,6 cases of pneumonia and 1 case of pulmonary hemorrhage.Among them,48 cases of RDS,15 cases of TTN,3 cases of pneumonia and 0 cases of pulmonary hemorrhage were diagnosed by LUS.40 cases of RDS,12 cases of TTN,5 cases of pneumonia and 0 cases of pulmonary hemorrhage were diagnosed by X-ray examination.(1)Statistical analysis showed that the sensitivity and specificity of LUS in diagnosing RDS were 96.0% and 78.9% respectively,while the sensitivity and specificity of LUS in diagnosing TTN were 78.9% and 100.0% respectively.The sensitivity and specificity of X-ray in diagnosing RDS were 80.0% and 84.2% respectively,while the sensitivity and specificity of X-ray in diagnosing TTN were 63.2% and 88.0% respectively.(2)The common ultrasonic manifestations of RDS,TTN,IPN and PHN were abnormal pleural line and a large number of b-line and a-line disappeared.RDS,IPN and PHN all had lung consolidation and air bronchogram,while TTN did not.(3)After 16 newborn were given PS,11 of them still had abnormal pleural line,8 had lung consolidation and air bronchi signs,9 had AIS or white lung manifestations,and 9 had line A.Conclutions:(1)Compared with X-ray,LUS has more advantages and higher diagnostic value in diagnosing RDS and TTN,and may become the preferred imaging examination method for neonatal physicians in the future.(2)RDS,TTN,IPN and PHN are four common pulmonary diseases with common ultrasonic manifestations.The differential diagnosis requires the combination of medical history and laboratory examination to accurately diagnose.(3)PS is not effective for severe,premature and very low birth weight infants after the first injection,so it should be supplemented with PS treatment again,or the observation time should be extended to 36 hours to evaluate the efficacy.But for mild,gestational age of the larger newborn treatment effect is significant.