本文選題：肺 + 超聲檢查　； 參考：《中國全科醫(yī)學(xué)》2017年36期

【摘要】：目的利用肺部超聲(LUS)觀察經(jīng)陰道產(chǎn)和剖宮產(chǎn)足月兒出后2 d內(nèi)肺液清除過程,以期為臨床指導(dǎo)治療提供借鑒。方法選取2015-11-13至2016-04-10在溫州醫(yī)科大學(xué)附屬第一醫(yī)院產(chǎn)科出生的新生兒50例為研究對象。根據(jù)分娩方式,將新生兒分為經(jīng)陰道產(chǎn)組(23例)和剖宮產(chǎn)組(27例);根據(jù)是否發(fā)生新生兒暫時性呼吸困難(TTN),將其分為TTN組(8例)和非TTN組(42例)。收集新生兒一般資料,分別于出生時(出生6 h內(nèi))、出生后第1天(6~24 h)、出生后第2天(24~48 h)進行LUS檢查,根據(jù)LUS視野內(nèi)B線的量及密集程度,將LUS檢查結(jié)果分為Ⅰ~Ⅳ級,其中Ⅰ~Ⅲ級定義為異常,Ⅳ級定義為正常。結(jié)果剖宮產(chǎn)組胎齡小于經(jīng)陰道產(chǎn)組,母親分娩時接受麻醉率、雙胎妊娠率大于經(jīng)陰道產(chǎn)組(P0.05)。TTN組5 min Apgar評分低于非TTN組,出生時接受呼吸支持治療率、出生后接受呼吸支持治療率高于非TTN組(P0.05)。經(jīng)陰道產(chǎn)組與剖宮產(chǎn)組出生時、出生后第1天、出生后第2天LUS分級比較,差異均無統(tǒng)計學(xué)意義(P0.05)。剖宮產(chǎn)組出生時LUS異常率高于經(jīng)陰道產(chǎn)組(P0.05);經(jīng)陰道產(chǎn)組與剖宮產(chǎn)組出生后第1天、出生后第2天LUS異常率比較,差異無統(tǒng)計學(xué)意義(P0.05)。經(jīng)陰道產(chǎn)組出生后第2天LUS異常率低于本組出生時(P0.05);剖宮產(chǎn)組出生后第1天、出生后第2天LUS異常率低于本組出生時,出生后第2天LUS異常率低于本組出生后第1天(P0.05)。TTN組與非TTN組出生時、出生后第1天LUS分級比較,差異無統(tǒng)計學(xué)意義(P0.05);TTN組出生后第2天LUS分級差于非TTN組(P0.05)。TTN組與非TTN組出生時、出生后第1天LUS異常率比較,差異無統(tǒng)計學(xué)意義(P0.05);TTN組出生后第2天LUS異常率高于非TTN組(P0.05)。結(jié)論與經(jīng)陰道產(chǎn)新生兒相比,剖宮產(chǎn)新生兒的肺液清除在出生后6 h內(nèi)存在障礙,但此差異在出生后6~24 h即消失。LUS可以動態(tài)觀察新生兒肺液清除過程,可指導(dǎo)臨床呼吸支持治療,值得在新生兒監(jiān)護病房推廣應(yīng)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，

本文編號：1749336