肺表面活性物质治疗新生儿呼吸窘迫综合征12例X线随访分析  

Diagnostic radiology for neonatal respiratory distress syndrome after pulmonary surfactant treatment:a report of 12 cases

作　　者：廖承德[1] 李杨芳[1] 张渝华[1] 石浩[1] 李红丽[1] 

机构地区：[1]云南省昆明市儿童医院,云南昆明650034

出　　处：《临床儿科杂志》2007年第1期62-64,共3页Journal of Clinical Pediatrics

摘　　要：目的探讨新生儿呼吸窘迫综合征(NRDS)使用肺表面活性物质后的胸部X线影像改变特点,分析可能的原因及其与治疗和预后的关系。方法回顾12例出生后经临床和影像学确诊为新生儿呼吸窘迫综合征,并使用肺表面活性物质(固尔苏)治疗病例,分析治疗后短期内(用药后2～6h)的胸部X线片及临床资料。结果复查胸片双肺透亮度恢复正常2例;较第一次胸片好转5例;病变无改变或进展5例。12例中出现肺及纵隔内气漏4例,其中伴随有肺部炎症改变3例。结论NRDS使用肺表面活性物质治疗后,部分病例短期内可有一侧或双侧肺透亮度增高、支气管充气征消失等改变,X线检查可反映药物的分布情况及间接评价疗效和预后;短期内X胸片复查能早期发现纵隔气肿、气胸、肺炎等并发症;有利于疾病的鉴别诊断。计算机放射系统(CR)在影像诊断中具有明显的优势。Objectives To investigate the appearance of chest X-ray in neonates with neonatal respiratory distress syndrome （NRDS） after pulmonary surfactant treatment. To analyses the possible causes of pathogenesis and relationship with clinical treatment or prognosis. Methods Retrospective review of 12 cases of NRDS diagnosed by clinical and chest X-ray, from January to December 2005. Analyze the symptom and chest X-ray taken in short time （2 - 6 hour） after treating by pulmonary surfactant （Curosurf） . Results X-ray re-inspectlon showed 2 cases with normal appearance, 5 cases with improvement, 5 cases with clinical stability, 4 cases with perforated diaphragm or pneumothoran, and 3 cases with pneumonic changes. Conclusions After pulmonary surfactant treatment in NRDS, some patients had X-ray changes within a short period of time, including the increase in pulmonary lucency and clearing of the air bronchus sign. The X-ray changes reflected the distribution of pulmonary surfactant and helped to evaluate the curative effect and prognosis. Diagnostic radiography also allowed early detection of complications such as perforated diaphragm, pneumothorax and pneumonia. Re-examination also facilitates differential diagnosis of various pulmonary diseases. Computer radiology （CR） has obvious advantages in the diagnosis of neonatal diseases.

关 键 词：呼吸窘迫综合征 肺表面活性物质 影像学 新生儿 

分 类 号：R722.1[医药卫生—儿科]