摘要
目的探讨肺脏超声在儿童社区获得性肺炎(community acquired pneumonia,CAP)诊断中的临床应用价值。方法对2019年5月-6月广西医科大学第五附属南宁市第一人民医院儿科一病区门诊连续就诊的130例疑似肺炎患儿于当天其他辅助检查前先行肺脏超声检查,将超声诊断结果与临床确诊的结果进行对照,总结肺炎组与无肺炎组患儿超声图像特征以及对肺脏超声诊断CAP的临床价值进行评价,评价指标为阳性预测值、阴性预测值、特异度、敏感度及准确度。结果肺炎组患儿肺脏超声声像图特征:(1)仅胸膜线异常5人(4.8%);(2)B-线征33人(31.7%);(3)肺实变5人(4.8%);(4)B-线征+肺实变49人(47.1%);(5)支气管充气征38人(36.5%);(6)支气管充液征11人(10.5%);(7)胸腔积液7人(6.7%);(8)肺不张4人(3.8%)。肺脏超声诊断儿童CAP的特异度为92.30%,敏感度为96.15%,准确度为95.38%,阳性预测值为98.03%,阴性预测值为85.71%。结论肺脏超声检查的敏感度较高,无辐射,无创伤,易于被患儿家属接受,是临床在诊断CAP中的又一影像辅助诊断方法,对指导临床诊断儿童CAP有较高的临床应用价值。
Objective To explore the clinical value of lung ultrasound in diagnosis of children with community acquired pneumonia(CAP).Methods 130 children with suspected pneumonia were examined by lung ultrasound before other auxiliary examinations in the First People’s Hospital of Nanning,Fifth Affiliated to Guangxi Medical University from May to June 2019.The results of ultrasonic diagnosis were compared with those of clinical diagnosis.The ultrasonographic characteristics of children in the pneumonia group and the non-pneumonia group were summarized and the clinical value of lung ultrasound in diagnosis of CAP was evaluated.The evaluation indexes were positive predictive value,negative predictive value,specificity,sensitivity and accuracy.Results The ultrasonographic characteristics of the lungs in the pneumonia group were as follows:5 cases with abnormal pleural line(4.8%),33 cases with B-line sign(31.7%),5 cases with lung consolidation(4.8%),49 cases with B-line sign and lung consolidation(47.1%),38 cases with bronchial inflation sign(36.5%),11 cases with bronchial fluid filling sign(10.5%),7 cases with pleural effusion(6.7%)and 4 cases with atelectasis(3.8%).Conclusion Lung ultrasonography has high sensitivity,no radiation,no trauma,and is easy to be accepted by children’s family.It is another image-assisted diagnosis method in clinical diagnosis of CAP,and has high clinical application value in guiding clinical diagnosis of children with CAP.
作者
庞光连
韦舒静
李婷婷
谭青兰
PANG Guang-Lian;WEI Shu-jing;LI Ting-ting;TAN Qing-lan(Department of Ultrasonography,the Fifth Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530022,China;Department of Pediatrics,the Fifth Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530022,China)
出处
《临床肺科杂志》
2020年第11期1655-1658,共4页
Journal of Clinical Pulmonary Medicine
基金
广西卫健委自筹经费科研课题(No.Z20190596)。
关键词
肺脏超声
社区获得性肺炎
诊断
lung ultrasound
community acquired pneumonia
diagnosis
