新生儿肺透明膜病45例X射线特征与临床分析

Clinical analysis and X-ray characteristics of 45 newborns with hyaline membrane disease

目的探讨新生儿肺透明膜病(HMD)的X射线特征与临床表现。方法回顾性分析45例HMD的X射线表现及临床资料。结果 45例患者中Ⅰ级12例,表现为肺野透亮度略减低,肺纹理增强,肺门影模糊,肺野内可见少许细小颗粒模糊影;Ⅱ级18例,表现为肺野透亮度减低,呈磨玻璃样改变,肺野内可见均匀分布的细小颗粒模糊影及支气管充气征,以及肺气肿、肺间质积液、叶间胸膜及胸腔积液等;Ⅲ级8例,表现为肺野内细小颗粒模糊影融合成斑片状,肺野透亮度明显减低,心缘及膈面模糊;Ⅳ级7例,表现为双肺呈"白肺"改变,部分可见支气管充气征,心缘及膈面消失。本组HMD患儿并发肺炎10例,气胸1例,先天性心脏病2例。治愈或好转40例。结论 HMD有典型的X射线表现,胸部X射线片是诊断HMD的可靠方法,并对观察疗效和病情变化有重要作用。

Objective To investigate the X-ray characteristics and clinical features of the newborns with pulmonary hyaline membrane disease（HMD）.Methods The X-ray manifestations and clinical data of 45 newborn patients with HMD were analyzed retrospectively.Results Among 45 cases,12 cases were gradeⅠ manifested by slight reduction of lung field transparency,increase of lung markings,blur of hilar shadow and a hint of fine particle blurry;18 cases were grade Ⅱmanifested by reduction of lung field transparency,change of ground glass shadows,uniform distribution of tiny particles fuzzy shadow in pulmonary field,air bronchus,emphysema,pulmonary interstitial effusion,interlobar pleural effusion and pleural effusion;8 cases were gradeⅢ manifested by fine praticle blurry fusing into patchy in pulmonary field,obvious reduction of pulmonary field transparency,and cardiac border and diaphragmatic surface becoming fuzzy;7 cases were grade Ⅳ manifested by＂white lung＂ change,partial air bronchus,and cardiac border and diaphragmatic surface disappearing.10 cases were complicated by pneumonia,1 case by pneumothorax,2 cases were congenital heart disease.40 cases were cured or improved.Conclusion Neonatal HMD has typical radiographic manifestations,so chest X ray is the reliable method to diagnose HMD and also plays an important role to observe the curative effect and the change of disease.