新生儿气胸26例临床分析

The clinical analysis of 26 cases of Newborn Pneumothorax

目的:探讨新生儿气胸的病因、临床特点及防治方法。方法:回顾性分析2003年5月至2011年4月我院收治的26例新生儿气胸患儿的临床资料。结果:26例均为继发性气胸,其中吸入性肺炎13例(50.0%),呼吸窘迫综合征11例(42.3%),肺炎合并呼吸窘迫综合征2例(7.7%)。出生时窒息14例(53.8%),窒息复苏使用呼吸囊6例(23.1%)。曾行机械通气17例(65.4%),使用肺表面活性物质7例(26.9%)。前四年气胸患儿12例,曾行机械通气4例;后四年气胸患儿14例,曾行机械通气13例,两组间机械通气比例有统计学差别(r=0.52,P<0.05))。双侧气胸3例(11.5%),单侧气胸23例(88.5%)。压缩面积>30%15例(57.7%),≤30%11例(42.3%)。23例治愈(88.5%),1例放弃治疗死亡,2例自动出院。结论:新生儿气胸常发生于原有肺部疾病的患儿,机械通气造成的医源性气胸也不少见。提高对新生儿气胸的认识,正确使用呼吸机及气囊复苏,可减少气胸发生。

Objective：To investigate the high-risk factors,clinical characteristics and preventing methods of newborn pneumothorax.Methods：The data were analyzed that 26 cases of newborn pneumothorax admitted in our hospital from Jan.2003 to Apr.2011.Results：26 cases were secondary pneumothorax,in which 13 cases were inhalant pneumonia（50.0%）,11 cases were respiratory distress syndrome（42.3%）,11 cases were respiratory distress syndrome and pneumonia（7.7%）.14 cases were asphyxia when born（53.8%）,6 examples cases used breathing lug in cardiopneumonopexy（23.1%）.17 cases once with machanical ventilation（65.4%）,7 cases used the lung surface-active substance（26.9%）.Two-sided pneumothorax 3 cases（11.5%）,single side pneumothorax 23 cases（88.5%）.The compression area,30% 15 cases（57.7%）,≤30% 11 cases（42.3%）.23 cases were cure（88.5%）,1 case death because of giving up treatment,2 cases discharged from hospital automatically.Conclusion：The newborn pneumothorax often occurs in the infants with original lung disease,the iatrogenic pneumothorax is not rare because of machanical ventilation.So enhancing the understanding of newborn pneumothorax,using the respiratory machine and breathing lug correctly,may reduce the occurrence of pneumothorax.