新生儿气胸的病因及救治策略

Etiology and treatment of neonatal pneumothorax

目的探讨新生儿气胸发生的病因、诊断及救治措施。方法回顾性分析2005年3月至2010年3月收住我院新生儿科的98例新生儿气胸的病因、诊治手段及预后。结果98例气胸患儿中，足月儿71例，早产儿27例；自发性气胸10例，非自发性气胸88例，分别给予原发病治疗、胸腔穿刺排气、胸腔闭式引流及机械通气等救治措施后，治愈88例，好转8例，死亡2例。结论新生儿气胸与剖官产、窒息复苏时正压通气过度、胎粪吸入、早产儿肺透明膜病应用肺表面活性物质及机械通气等因素有关，绝大部分继发于肺部疾病。预防早产和窒息，避免错误的气道加压，可减少气胸的发生。

Objective To investigate the cause, diagnosis and treatment measures of neonatal pneumothorax. Methods The clinical data of 98 cases with neonatal pneumothorax in our hospital from Mar 2005 to Mar 2010 were reviewed retrospectively. Results There were 27 premature neonates and 71 full-term neonates in the 98 cases. Ten cases were spontaneous pneumothorax and 88 cases were non spontaneous pneumothorax. After the treatment of primary disease, pleural aspiration, chest drainage and mechanical ventilation, 88 cases were cured,8 cases were improved and 2 cases died. Conclusion Neonatal pneumothorax is related with cesarean section, improper use of endotracheal intubation, meconium aspiration, premature hyaline membrane disease using pulmonary surfactant and ventilator therapy. Most pneumothorax is due to lung disease. The prevention of preterm birth and asphyxia can reduce the incidence of neonatal pneumothorax.