肺超声十四分区评分法在新生儿呼吸窘迫综合征病情评估中的应用价值OA

Objective:To investigate the application value of fourteen-zone pulmonary ultrasound scoring in assessing the severity of neonatal respiratory distress syndrome(NRDS)and monitoring the efficacy of pulmonary surfactant(PS)therapy.Methods:A total of 92 NRDS infants admitted to our hospital from September 2022 to March 2024 were enrolled and divided into non-critical(38 cases)and critical(54 cases)groups based on the oxygenation index(OI).Pulmonary ultrasound examinations were performed using a Canon Aplio300 ultrasound diagnostic instrument with a 12 MHz high-frequency probe.The lung ultrasound images of the two groups were scored using the fourteen-zone scoring method.Clinical blood gas analysis indices were also collected and analyzed.By comparing the detection rates of ultrasound signs,lung ultrasound scores(LUS),and score changes before and after PS treatment between the two groups,the diagnostic efficacy and dynamic monitoring value of the fourteen-zone pulmonary ultrasound scoring method were assessed.Results:There were no significant differences in the detection rates of pleural line abnormalities,A-line disappearance,ground-glass opacities,and confluent B-lines between the non-critical and critical groups(P>0.05).However,the detection rates of consolidation with air bronchogram and pleural effusion were significantly higher in the critical group than in the non-critical group(P<0.05).The optimal cut-off value of the fourteen-zone scoring method for predicting severe NRDS was 35.5 points,with a specificity of 92.10%and a sensitivity of 75.90%.Additionally,LUS was positively correlated with arterial partial pressure of carbon dioxide(PaCO2)(r=0.65,P<0.05)and negatively correlated with arterial partial pressure of oxygen(PaO2)and oxygenation index(OI)(r=-0.73,P<0.05;r=-0.83,P<0.05,respectively).After PS treatment,LUS gradually decreased in both groups,and LUS in the non-critical group was always lower than that in the critical group(P<0.05).Conclusion:The fourteen-zone pulmonary ultrasound scoring method can accurately assess the severity of NRDS and effectively monitor changes in condition after PS treatment.This method provides a powerful imaging basis for clinical diagnosis and treatment and deserves further promotion and application.