新生儿肺透明膜病的X线诊断与临床分析

Clinical analysis and X-ray diagnosis of pulmonary hyaline membrane disease in newborns

目的 探讨新生儿肺透明膜病 (HMD)的X线表现特征。方法 回顾性分析深圳市人民医院 2 0 0 0年 1月至2 0 0 2年 12月收治的 70例HMD患儿的X线表现等临床资料。结果 70例中 7例肺野可显示网格及斑点状密度增高阴影 ,4 3例表现为肺野透光度减低、两肺大片不均匀的致密阴影 ,1例仅表现肺纹理增强 ,4 1例可见空气支气管征。 70例的并发症有 :肺炎 5 0例 ,颅内出血 8例 ,气胸和气漏共 9例 ,肺出血 9例 ,动脉导管未闭 3例 ,新生儿坏死性小肠结肠炎 7例 ,缺血缺氧性脑病 9例 ,支气管肺发育不良 4例 ,所有病例肺容量均正常。X线表现分级与出生时平均体重及平均发病时间呈负相关。结论 胸部X线检查对HMD诊断及预后的判断具有重要价值 。

Objective To evaluate x ray features of pulmonary hyaline membrane disease(HMD)in newborns.Methods The data of 70 cases of HMD were analyzed retrospectively.Results Of the 70 cases,reticular and spot like high density shadow in both lung fields were found in 7 cases,hypolucency and patchy inhomogeneous density shadow in both lung fields in 43,and lung marking exaggerated in one case.Air bronchogram appeared in 41 cases.Complications of these patients included pneumonia (n=50),intracranial hemorrhage (n=8),pneumothorax (n=6),lung bleeding (n=9),patent ductus arteriosus (n=3),newborn necrotic enterocolitis (n=7).All the newborns had normal pulmonary volume.There were negative correlations between classification of x ray findings and average birth weight or average onset time.Conclusion X ray check up plays an important role in the diagnosis of HMD and evaluation of the prognosis.