新生儿医源性气胸的病因及预防

The etiology and prevention of neonatal iatrogenic pneumothora

近年来，剖宫产率有不断上升的趋势，其产生的不良反应也开始引起国内外临床医生的重视。文献报道足月剖宫产尤其是选择性剖宫产，新生儿气胸发病率显著高于自然分娩儿及非选择性剖宫产儿。另外，随着新生儿重症监护病房的广泛建立及呼吸机的普及应用，危重新生儿的抢救成功率明显提高，但气胸发病率也随之上升。研究表明，选择性剖宫产及机械通气与新生儿医源性气胸高度相关，临床上应严格掌握剖宫产及机械通气的适应证。

The side effects of cesarean with the increasing rate section began to attract the attention of pediatricians in recent years. Previous studies reported that the incidence of neonatal pnermothorax by full-term cesarean section, especially selective cesarean section, was significantly higher than vaginal birth or non-selective cesarean section. In addition, with an extensive establishment of NICUs in China and widely use of mechanical ventilation, the rate of successful neonatal rescue was improved obviously, but the incidence of pneumothorax was increasing. Studies suggested that the incidence of neonatal iatrogenic pneumothorax was highly relevant with selective cesarean section and mechanical ventilation. The indications for cesarean section and mechanical ventilation should be carefully considered.