新生儿肺出血66例临床病理分析

Clinical and Pathological Analysis on 66 Cases of Neonatal Pulmonary Hemorrhage

目的探讨新生儿肺出血的高危因素、早期临床表现及诊断。方法回顾性分析66例新生儿肺出血死亡病例的临床表现、胸部X线检查及病理资料。结果早产、低出生体质量、严重缺氧、感染是新生儿肺出血的高危因素;肺出血早期临床表现为在原发疾病基础上突然出现呼吸困难加重,肺部出现湿音或湿音明显增加;双肺野透亮度广泛、均匀降低伴小斑点状影,肋间隙增宽为早期X线征象;尸体解剖病理表现为肺水肿伴少量出血。结论对有肺出血高危因素及早期临床表现的患儿,应及早诊断,早期干预。

Objective To explore the higher dangerous factors, the early clinical performances and its contents of neonatal pulmonary hemorrhage（NPH）. Methods The clinical performances,chest radiograms and autoptical pathological materials of 66 cases of newborns who died of NPH at our neonatal department during 1993 to 2003 were reviewed and analyzed. Results The higher dangerous/actors of NPH were premature delivery/low birth weight, serious diseases lead to hypoxia and severe infections. The early clinical performances of NPH were the suddenly aggravation of dyspnea and the increasing of moist sounds. The early X-ray performances were lower penetrance of lung fields extensively and well-distributly with path clouds, the intercostals space usually increased. According to the autoptical pathology, this X-ray perfomance indicated the edema of the pulmonary with small amount of hemorrhage, Conclusion The patients with the higher dangerous factors and the early clinical performances of NPH,must be diagnosed and interfered it as early as possible to reduce the mortality of NPH.