X线胸片对新生儿常见肺疾患诊断和预后评估的价值

The Role of Chest X-ray in the Diagnosis and Prognostic Assessment in Neonatal Common Lung Diseases

目的:分析新生儿常见肺疾患的临床和胸片特征,探讨X线胸片在该类疾病诊断及预后评估中的价值。方法:对50例新生儿湿肺症(WLD)、45例胎粪吸入综合征(MAS)、31例呼吸窘迫综合征(NRDS)、25例肺出血(NPH)X线诊断结果与临床资料、病理报告进行对比分析。结果:本组影像诊断总准确率为96.7%。WLD病程短,预后良好,X线表现演变迅速;NRDS症状出现早,病程长,萎陷的肺野内大量含气支气管影;MAS临床无特异性,影像表现复杂,肺野呈现羊水异物影;NPH起病急,发展快,以出血性肺水肿为主要表现。结论:新生儿常见肺疾患具有支气管充气征、蝴蝶征和肺野异物等多种特征性胸片表现,并可以通过对胸片征象及其演变规律的分析,判定病变严重程度及预后转归。

Objective: To analyze the clinical features and chest X-ray findings, to discuss the value of chest X-ray in diagnosis and prognosis in neonatal common lung diseases. Methods: The radiographic findings in 50 WLD cases, 45 MAS cases, 31 NRDS cases and 25 NPH cases have been compared with the clinical features. Results: Ninety six point seven percent cases in this study have been diagnosed correctly by way of the X-ray chest. WLD is a kind of self-limited disease, which is more often happened in mature newborn. It has a short pathologic course and a better result. X-ray findings change rapidly. NRDS is either self-limited disease or serious illness apt to death. The MAS is a serious disease of newborn. It has no special clinical features in comparison to other common lung disease in the newborn. It is of complex imaging findings. NPH is a dying state resulted from many different diseases. It happens suddenly and changes fast. Megacardia is the early X-ray manifestation of NPH. Conclusion: Most of the common lung diseases in the newborn are of typical clinical features and X-ray findings. Chest X-ray is a very important tool for the diagnosis and prognosis prediction in the common lung diseases in newborn.