Two years of clinical practice in the diagnosis of pulmonary diseases by ultrasound instead of X-ray in neonatal ward / 中国小儿急救医学

ABSTRACT

Objective To summarize the routine application of neonatal lung ultrasound in neonatal and NICU department of our hospital in the past 2 years,and to explore the feasibility of using ultrasound in-stead of X-ray in diagnosing pulmonary diseases in neonatal ward. Methods From March 2017 to May 2019,a total of 2 874 children hospitalized in the department of neonatology in our hospital were collected to analyze the types of pulmonary diseases and the reliability of lung ultrasound diagnosis. Results A total of 2 874 children received lung ultrasound examination for 7 902 times,including 1 040 patients(36. 2%) with pulmonary disease and 1 834 patients(63. 8%)without pulmonary disease. There were 152 cases of neonatal respiratory distress syndrome,112 cases of wet lung,652 cases of pneumonia,87 cases of meconium aspira-tion syndrome,12 cases of pneumothorax ( including 1 case with mediastinal emphysema),and 25 cases of pulmonary hemorrhage. Among the 2 874 children,106 received X-ray examination of the lungs before admis-sion,and received dynamic monitoring of lung ultrasound. Ninety-six cases were found to have pulmonary lesions,among which 8 cases were diagnosed with neonatal respiratory distress syndrome by X-ray examina-tion and wet lung by lung ultrasound,and recovered quickly after treatment according to wet lung. In 2 cases, X-ray examination showed no pneumonia complicated with pneumothorax,while ultrasound diagnosis showed a small amount of pneumothorax, and ultrasound diagnosis showed pneumonia complicated with a small amount of pleural effusion in 1 case. The diagnostic coincidence rate was 91. 7%. Conclusion It is feasible to use ultrasound instead of X-ray to diagnose pulmonary diseases in neonatal wards. Ultrasonic diagnosis of neonatal pulmonary diseases is worth promoting.