肺部超声观察不同分娩方式足月儿出生后2日内肺液清除状态的价值研究

发布时间：2018-04-14 12:31

  本文选题：肺 + 超声检查　； 参考：《中国全科医学》2017年36期

【摘要】：目的利用肺部超声(LUS)观察经阴道产和剖宫产足月儿出后2 d内肺液清除过程,以期为临床指导治疗提供借鉴。方法选取2015-11-13至2016-04-10在温州医科大学附属第一医院产科出生的新生儿50例为研究对象。根据分娩方式,将新生儿分为经阴道产组(23例)和剖宫产组(27例);根据是否发生新生儿暂时性呼吸困难(TTN),将其分为TTN组(8例)和非TTN组(42例)。收集新生儿一般资料,分别于出生时(出生6 h内)、出生后第1天(6~24 h)、出生后第2天(24~48 h)进行LUS检查,根据LUS视野内B线的量及密集程度,将LUS检查结果分为Ⅰ~Ⅳ级,其中Ⅰ~Ⅲ级定义为异常,Ⅳ级定义为正常。结果剖宫产组胎龄小于经阴道产组,母亲分娩时接受麻醉率、双胎妊娠率大于经阴道产组(P0.05)。TTN组5 min Apgar评分低于非TTN组,出生时接受呼吸支持治疗率、出生后接受呼吸支持治疗率高于非TTN组(P0.05)。经阴道产组与剖宫产组出生时、出生后第1天、出生后第2天LUS分级比较,差异均无统计学意义(P0.05)。剖宫产组出生时LUS异常率高于经阴道产组(P0.05);经阴道产组与剖宫产组出生后第1天、出生后第2天LUS异常率比较,差异无统计学意义(P0.05)。经阴道产组出生后第2天LUS异常率低于本组出生时(P0.05);剖宫产组出生后第1天、出生后第2天LUS异常率低于本组出生时,出生后第2天LUS异常率低于本组出生后第1天(P0.05)。TTN组与非TTN组出生时、出生后第1天LUS分级比较,差异无统计学意义(P0.05);TTN组出生后第2天LUS分级差于非TTN组(P0.05)。TTN组与非TTN组出生时、出生后第1天LUS异常率比较,差异无统计学意义(P0.05);TTN组出生后第2天LUS异常率高于非TTN组(P0.05)。结论与经阴道产新生儿相比,剖宫产新生儿的肺液清除在出生后6 h内存在障碍,但此差异在出生后6~24 h即消失。LUS可以动态观察新生儿肺液清除过程,可指导临床呼吸支持治疗,值得在新生儿监护病房推广应用。
[Abstract]:Objective to observe the clearance process of pulmonary fluid in 2 days after vaginal delivery and cesarean section by using pulmonary ultrasound (LUSS) in order to provide reference for clinical treatment.Methods 50 newborns born in obstetrics department of the first affiliated Hospital of Wenzhou Medical University from May 11 to 13 to April 10, 2016-10 were selected as subjects.According to the mode of delivery, the newborns were divided into transvaginal delivery group (n = 23) and cesarean section group (n = 27), TTN group (n = 8) and non- group (n = 42).The general data of newborns were collected and LUS was performed at the time of birth (within 6 hours of birth, 6 hours after birth, 24 hours after birth and 24 hours after birth). According to the quantity and density of B line in LUS field, the results of LUS examination were classified as 鈪，

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