探讨肺部超声（LUS）在评估新生儿呼吸窘迫综合征（NRDS）使用肺表面活性物质（PS）治疗效果中的临床价值。

前瞻性选取2018年5月至2018年12月于空军军医大学唐都医院新生儿重症监护室（NICU）收治的NRDS患儿共37例，依据临床是否应用PS治疗分为2组，其中治疗组27例，选用猪肺磷脂注射液（固尔苏）经气管插管给药；对照组10例，不使用任何PS治疗。2组患儿在入组后均行LUS检查，观察超声图像特征并进行评分，治疗组另分别观察治疗后4 h、1 d、3 d超声图像及评分变化。

对照组LUS评分显著低于治疗组（11.20±2.10 vs 20.59±5.46），2组比较差异有统计学意义（t=-7.561，P<0.001）。治疗组在使用固尔苏治疗不同时间点LUS评分比较差异有统计学意义（F=30.453，P<0.001），其中治疗组在使用固尔苏治疗后4 h与治疗前相比，LUS评分明显下降（14.30±4.79 vs 20.59±5.46），2者比较差异有统计学意义（P<0.001）；治疗后1 d与治疗后4 h比较，LUS评分差异无统计学意义（P=0.389）；治疗后3 d相较于治疗后1 d，LUS评分差异无统计学意义（P=0.136）；治疗后3 d与治疗后4 h相比，LUS评分显著降低（9.12±3.45 vs 14.30±4.79），2者比较差异有统计学意义（P=0.001）。对照组LUS图像表现为轻度肺泡间质综合征，治疗组表现为"白肺"及肺实变，固尔苏治疗4 h后"白肺"变为稀疏B线，肺实变范围明显缩小。

LUS可以早期预测NRDS患儿是否需要应用固尔苏进行治疗，并实时监测治疗效果，为NRDS患儿的临床用药和治疗监测提供重要信息和依据。

To evaluate the clinical value of lung ultrasound (LUS) in evaluating the therapeutic effects of pulmonary surfactants (PS) for neonatal respiratory distress syndrome (NRDS).

From May 2018 to December 2018, a total of 37 NRDS newborns admitted at neonatal intensive care unit (NICU) of Tangdu Hospital of the Air Force Military Medical University were prospectively divided into either a therapeutic group or a control group based on the application of PS treatment or not. The therapeutic group included 27 cases treated with poractant α (Curosurf) by endotracheal intubation, and the control group included 10 cases who did not use any PS treatment. Pulmonary ultrasound was performed in both groups after enrollment. The characteristics of ultrasound images and lung ultrasound scores were recorded. In the therapeutic group, the changes of ultrasound images and scores were also observed at 4 h, 1 d, and 3d after treatment.

LUS score in the control group was significantly lower than that in the therapeutic group (11.20±2.10 vs 20.59±5.46, t=-7.561, P<0.001). LUS scores in the treatment group were significantly different among different time points (F=30.453, P<0.001). At 4 h after treatment, LUS score of the examined regions was significantly decreased compared with that before treatment (14.30±4.79 vs 20.59±5.46, P<0.001). LUS score showed no significant changes at 1d after treatment compared with that at 4 h (P=0.389). However, LUS score was significantly lower at 3 d after treatment than at 4 h (9.12±3.45 vs 14.30±4.79, P=0.001). In the control group, LUS images showed mild alveolar interstitial syndrome. However, in the therapeutic group, "white lung" and lung consolidation were noted. At 4 h after PS administration, "white lung" dramatically changed to isolated B lines, and the lung consolidation was significantly reduced.

LUS could be used to early predict whether newborns with NRDS need to be treated with Curosurf, monitor the therapeutic effects in real time, and provide important information for clinical drug use and treatment monitoring of NRDS in NICU.