肺脏超声对早产儿长期氧依赖肺部原因的鉴别价值

目的 肺脏超声已经广泛应用于肺脏疾病的诊断与鉴别诊断,本文旨在研究肺脏超声对明确早产儿长期氧依赖肺部原因的可行性与必要性.方法 对临床上诊断为支气管肺发育不良（bronchopulmonary dysplasia,BPD）的50例患儿进行肺脏超声筛查,并记录相关所见结果.结果 50例临床诊断为BPD的患儿中,肺脏超声检查发现肺不张9例、肺炎4例、严重肺水肿2例、肺水肿伴局灶性肺实变3例.对其进行相应处理后,患儿对氧的依赖消肖失或程度明显减轻,即超过1/3（36％,18/50）患儿的氧依赖并非BPD或非单纯BPD引起.结论 肺脏超声对协助诊断与鉴别患儿长期氧依赖的肺部病因有重要价值,有助于避免诊断扩大化及指导治疗,提示有必要对目前使用的BPD诊断标准予以修订.

Using lung ultrasound to difference the pulmonary reasons of long-term oxygen dependence in premature infants

Objective Lung ultrasound has been used extensively to diagnose many types of lung disease.This study aimed to evaluate the pulmonary reasons for long-term oxygen dependence （LTOD） in premature infants using lung ultrasound.Methods Lung ultrasound was routinely performed in 50 premature infants clinically diagnosed with bronchopulmonary dysplasia（BPD）.Results Among the 50 patients studied,there were 9 cases of atelectasis,4 cases of pneumonia,2 cases of severe pulmonary edema,and 3 cases of pulmonary edema and consolidation that coexisted with BPD.The babies＆#39; oxygen dependence either resolved completely or significantly decreased following appropriate treatments.Conclusion More than onethird of the cases of LTOD in premature babies were caused by either BPD alone or diseases other than BPD.Lung ultrasound plays an important role in differentiating pulmonary causes of LTOD in BPD patients,and the results of our study suggest that modifying the diagnostic criteria for BPD may be necessary.