作　　者： ; ; ; ; ;

机构地区： 深圳市宝安区妇幼保健院

出　　处： 《中国实用儿科杂志》 2020年第6期478-481,共4页

摘　　要： 目的观察比较常规肺脏超声检查和急诊床边肺脏超声检查流程(BLUE)方案这两种方法对儿童重症监护室(PICU)呼吸困难患儿诊断的价值。方法对2017年9月1日至2019年5月31日在深圳市宝安区妇幼保健院儿科住院的217例呼吸困难患儿进行常规肺脏超声检查和BLUE方案检查。结果217例中有肺脏疾病者186例,占85.7%;无肺脏疾病者31例,占14.3%。186例肺脏疾病患儿中,重症肺炎89例(47.8%),毛细支气管炎43例(23.1%),支气管哮喘34例(18.3%),喉炎12例(6.5%),呼吸窘迫综合征(ARDS)8例(4.3%)。32例呼吸困难患儿胸部X线检查未见肺水肿、斑片状、点状影等异常征象,但在常规超声下均发现肺实变和(或)肺间质综合征等异常征象。217例患儿中,因BLUE方案错误诊断者37例,常规肺脏超声结果和BLUE方案检查结果的差异有统计学意义(P<0.001)。结论肺脏超声在PICU呼吸困难患儿中的应用是可行的,但使用BLUE方案时要谨慎,以避免由此导致错误的诊疗方案。 Objective To assess the diagnostic value of the routine lung ultrasound and bedside lung ultrasound in emergency(BLUE)protocol in children with dyspnea.Methods Totally 217 children with dyspnea hospitalized from Sep 1,2017 to May 31,2019,in Shenzhen Bao’an Maternal and Child Health Hospital,were included in this study.All the children were examined by LUS and BLUE protocol of LUS.Results There were 186 patients(85.7%)with lung diseases and 31(14.3%)without lung diseases.The cases with lung diseases were as follows:89 cases(47.8%)of severe pneumonia,43 cases(23.1%)of capillary bronchitis,34 cases(18.3%)of bronchial asthma,12 cases(6.5%)of laryngitis and 8 cases(4.3%)of acute respiratory distress syndrome(ARDS).The 32 cases among 217 children in which abnormal signs couldn’t be found by X-ray were found with lung consolidation and/or interstitial syndrome by LUS.There were 37 cases among 217 children which were misdiagnosed by the BLUE protocol of LUS,the difference between the results of regular LUS and BLUE protocol was statistically significant(P<0.001).Conclusion The diagnosis by LUS is feasible in children with dyspnea in PICU.However,the use of the BLUE protocol should be with care in order to avoid errors.

关 键 词： 儿童 呼吸困难 肺脏超声 急诊床边肺脏超声检查流程 重症监护室

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