早产儿慢性肺部疾病13例报告

Study on 13 premature infants with chronic lung disease.

目的 探讨早产儿慢性肺部疾病 (CLD)的临床表现形式、病因、治疗和预后。方法 对 1998年 10月至2 0 0 2年 3月在我院NICU住院的 13例CLD患儿的临床表现形式、病因、治疗和预后进行观察和总结。结果 ①13例中 8例以感染性肺炎入院 ,5例胸片未见异常 ;② 6例应用机械通气 ,除 1例外 ,持续时间为 3～ 4d ,设置的PIP、FiO2 参数值均较低 ;其余患儿给予CPAP或面罩给氧 ,辅助用氧时间为 (48 38± 2 0 47)d[(30～ 92 )d];③ 10例合并“婴儿肝炎”综合征 ,5例死亡 ,5例治愈 ;④生后 3～ 4周时 5例胸片仍异常 ,8例胸片未见异常 ,后者行胸部CT检查 ,符合BPD特征性影像学改变 ;⑤ 6例生后第 4周应用地塞米松治疗 ,其中 1例存活 ;⑥ 6例CLD存活 ,其中 2例出院后易患呼吸系统感染 ;7例死亡。结论 CLD的非典型表现形式是其最常见形式 ;肺部CT在诊断CLD中具有重要价值 ;该病病死率高 ,寻找有效的治疗方案是亟待解决的问题。

Objective To explore the clinical features,etiology,treatment and prognosis of chronic lung disease.Methods Observing and analyzing the clinical characteristics,etiology,treatment and prognosis of CLD in 13 infants that were hospitalized in NICU during the period from October 1998 to March 2002.Results ①8 of 13 infants were admitted for infective pneumonia, the chest radiographs were normal in the remaining 5 cases;②6 cases required mechanical ventilation for 3 to 4 days except 1 case,requiring minimal ventilation and low concentration of oxygen;the others required CPAP or oxygen masks, duration of supplemental oxygen were 48 38±20 47(30～92)d;③10 infants were complicated with hepatitis syndrome;5 infants died,the other 5 cases were cured;④Chest radiographs were still abnormal in 5 cases at to 4 weeks after birth,and CT reveal significant changes of BPD in the remaining 8 cases who had normal X-ray;⑤6 infants received a 7-day course of dexamethasone therapy at 4 weeks after birth,1 of them survived;⑥6 infants cured,and 2 of them had an increased incidence of respiratory tract infection after discharge,7 infants died.Conclusions Atypical presentation of CLD are more frequently observed.Chest CT is important in diagnosis CLD.The mortality is high.It’s urgent to find effective ways of treatment.