数字床旁DR平片对新生儿透明膜病的诊断价值

Digital bed DR fl at piece of value to the diagnosis of neonatal hyaline membrane disease

目的探讨数字床旁DR平片对新生儿透明膜病(HMD)的诊断及应用价值。方法回顾性分析本院新生儿科于2009年1月至2014年10月收治的117例经临床和病理确诊为新生儿透明膜病患儿的床旁X线平片。结果 120例中,新生儿透明膜病Ⅰ级27例(占23%),表现为双肺纹理增多且透亮度降低,双肺内见弥漫性细颗粒状及网格状阴影;Ⅱ级33例(占28%),表现为双肺呈磨玻璃样改变,并出现支气管充气征;Ⅲ级36例(占31%),表现为透亮度较Ⅱ级进一步降低,细小颗粒影进一步融合增大成片状,支气管充气征更加明显,心膈影模糊;Ⅳ级21例(占18%),表现为患儿出现"白肺",心缘及膈面消失;并发症中合并肺出血9例(占8%),肺炎18例(占16%),气胸9例(占8%)。结论新生儿透明膜病具有较为典型的X线征象。床旁DR对诊断HMD具有不可替代的作用。

Objective：To explore the digital bed DR plain film in the diagnosis of neonatal hyaline membrane disease（HMD）and its application value. Methods：A retrospective analysis to our hospital freshmen in pediatrics in January 2009 to October 2014,117 cases of the clinical and pathological diagnosis of children with neonatal hyaline membrane disease of bedside X-ray plain film. Results：120 cases of neonatal hyaline membrane disease Ⅰ level 27 cases（23%）,and characterized by double increase transparency and reduce lung texture,double lung diffuse fine granular and grid within a shadow;Ⅱ level 33cases（28%）,characterized by double lung change in grinding of glass samples,air-filled bronchi and has;Ⅲ level 36 cases（31%）,characterized by Ⅱ level further reduce transparency,tiny particles increases shadow further integration into flake,air-filled bronchi character more obvious,heart diaphragmatic shadow vague;Ⅳ level 21 cases（18%）,characterized by children appear ＂white lung＂,heart margin and diaphragmatic surface disappear;Complication with pulmonary hemorrhage in 9 cases（8%）,pneumonia 18 cases（16%）,and pneumothorax 9 cases（8%）. Conclusion：Neonatal hyaline membrane disease has a more typical X-ray signs. Bed DR plays an irreplaceable role in diagnosis of HMD.