60例肺透明膜病及其并发症的X线观察

X - ray observation of 60 cases of hyaline membrane disease of lung and it's complications

目的:分析肺透明膜病及其并发症X线表现。材料和方法:对确诊HMD60例的临床、X线及部分病理资料进行回顾性分析。所有病例在气管插管机械通气治疗前作了胸腹照片检查,除14例入院当天死亡外,其余均作了1-6次不等照片复查。结果:根据文献提出的分级标准,以第一次照片为分析依据,X线照片结果如下:Ⅰ级4例(6.67％),Ⅱ级11例(18.33％),Ⅲ级23例(38.33％),Ⅳ级22例(36.67％)。动态照片发现:5例X线表现升级,27例有不同程度的好转。本组病例并发症较多,主要有重度肺气肿、肺不张各3例,气胸4例,肺炎11例,肺出血7例,BPD 2例,NEC 4例,PDA 19例。结论:X线照片动态观察不但可以明确诊断,同时对及时发现各种并发症,评估预后具有重要意义。

Objective: To analyze X - ray findings of hyaline membrane disease (HMD) of lung and it's complications. Methods The materials of clinic, X - ray, and pathology of 60 infants with HMD were reviewed. Before intratracheal intubation and ventilator support, a chest and abdomen radiogram was taken in all cases, and all cases were re - examinedone to six times except 14 cases died on the day presented. Results According to classification recommended by literature and based on the first radiogram features, the patients were classified as: grade Ⅰ: 4 cases (6. 67% ), grade Ⅱ: 11 cases( 18. 33% ), grade Ⅲ: 23 cases(38. 33% ), grade Ⅳ: 22 cases (36.67%) .It was found by dynamic examination that Scases has a higher degree of grade classification consecutive radiograms; 27 cases showed improvement. The complications of HMD included sever emphysem (3 cases), atelectasis (3 cases), pneumothorax (4 cases), pneumonia (11 cases), pulmonary hemorrhage (7 cases), BPD (2 cases), PDA(19cases), necrotic enterocolitis (4 cases). Conclusion The dynamic observation of radiograms could not only establish diagnosis but also could find complications promptly and evaluate the prognosis correctly.