新生儿气胸的X线与CT检查分析

Analysis of X Ray and CT Examination of Aerothorax in Newborns

目的分析新生儿气胸的X线检查表现特征,以提高对新生儿气胸的认识与X线诊断水平。方法对该院2011年1月—2016年12月近6年来收治的52例新生儿气胸患儿,摄取仰卧前后位和部分仰卧水平侧位胸片,25例有多次随访片,其中8例患者还进行了胸部CT扫描。观察新生儿气胸的胸部X线表现特征,气胸量与临床治疗方案、预后的相关性。结果该组52例新生儿气胸患儿中,29例单侧气胸,其中并纵膈气肿9例;15例双侧气胸,其中并纵膈气肿4例;8例纵膈积气。正位X线片显示纵隔心影旁宽窄不一的透亮区为8例,肺野区不规则透亮区9例,外带压缩肺组织17例,肋膈角区异常透光区2例,膈面上异常透光区4例,其余正位X线片未发现异常,侧位X线片均显示为胸骨后大小不一的异常透光区。结论由于新生儿多采用卧位摄片,因此其气胸与年长儿、成人的X线表现不同,气体多聚集在胸腔前部和内侧,并常伴有纵隔积气。目前胸部X线检查仍是确诊新生儿气胸的首选检查方法,对临床诊断并及时处理有重要意义。

Objective To analyze the manifestation features of X ray and CT examination of aerothorax in newborns in order to improve the awareness of aerothorax in newborns and X ray diagnosis level. Methods 52 cases of newborns with aerothorax admitted and treat- ed in our hospital in recent six years from January 2011 to December 2016 were selected and the 25 cases had the multiple follow-up films, and 8 cases were given the chest CT scanning, and the manifestation features of chest X ray, aerothorax amount and clinical treatment plan and prognosis were observed. Results of 52 cases of newborns with aerothorax, there were 29 cases with unilateral pneumothorax, including 9 cases with unilateral pneumothorax and mediastinal emphesema, and 15 cases were with bilateral pneu- mothorax, including 4 cases with bilateral pneumothorax and mediastinal emphesema and 8 cases with pneumomediastinum, and the shoulder X film showed that there were 8 cases whose mediastinal heart shadow lucent area was with uneven width, 9 cases with irreg- ular lung field region and 17 cases with compression lung tissues, and2 cases with abnormal costophrenic angle region, 4 cases with abnormal diaphragmatic surface, and the other X ray films were not discovered abnormal and the lateral X ray film showed the differ- ent sizes of abnormal substernal photic zones. Conclusion Because most newborns use the recumbent position film, the x ray manifes- tations of them are different from those of elderly children and aduhs, and most gas is in the front and inner side of the ribcage, and often with pneumomediastinum, currently, the chest X ray examination is also the primary examination method of diagnosis of aerotho- rax in newborns, and it is of imoortant significance to the clinical diagnosis and timelv handling.