新生儿肺炎合并气胸26例临床分析  

Clinical analysis of 26 neonatal pneumonia patients complicated with pneumothorax

作　　者：刘素琴[1] 张燕萍[1] 金玉[1] 

机构地区：[1]扬州市妇幼保健院儿科,江苏省扬州225002

出　　处：《中国基层医药》2013年第21期3263-3265,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨新生儿肺炎合并气胸的临床特点与防治措施.方法 对26例肺炎合并气胸患儿的临床资料进行整理、回顾性分析.结果 26例新生儿肺炎合并气胸中16例（61.5％）为吸入性肺炎合并气胸；10例（38.5％）为感染性肺炎合并气胸,饱和度进行性下降等,一侧或两侧胸廓明显隆起,经胸腔穿刺排气或胸腔闭式引流.轻度发绀及呼吸困难不明显者予保守治疗；24例气促发绀、呻吟、面苍、呼吸困难、烦躁不安、易激惹等,听诊呼吸音减轻或消失,心音移位,发绀予吸氧不能持续缓解,24例（92.5％）患儿气胸治愈；2例（7.7％）放弃治疗,其中1例随防死亡,1例失防.结论 新生儿肺炎合并气胸大部分继发于吸入、感染,不适当气道加压、吸痰等,一旦发现,及时处理,轻度发绀自行缓解,发绀予吸氧等不能持续缓解,经胸腔穿刺排气或胸腔闭式引流,预后良好,积极控制孕期、产时、产后感染,防止胎粪吸入可减少新生儿肺炎合并气胸的发生.Objective To explore the clinical features and prevention measures of neonatal pneumonia complicated with pneumothorax.Methods Clinical data of 26 neonatal pneumonia patients complicated with pneumothorax were retrospectively analyzed.Results In 26 cases of neonatal pneumonia complicated with pneumothorax,16 cases（61.4％） were aspiration pneumonia,10 cases（38.5％） were infectious pneumonia.2 cases of not obvious mild cyanosis and dyspnea were given conservative treatment,24 cases were shortness of breath cyanosis,groan,face pale,difficulty in breathing,restlessness,irritability.Breath sounds were reduced or disappear,sound shift,cyanosis to oxygen can not be sustained remission.Blood oxygen saturation were lower grade.One side or both sides of the chest profile were apparent uplift with thoracic puncture exhaust or thoracic closed drainage.24 cases（92.5％） suffered from pneumothorax were cured.2 cases （7.7％） gave up the treatment,including 1 case died and 1 case loss prevention.Conclusion Pneumonia of newborn pneumothorax is secondary to inhalation of most inappropriate,infection,airway pressure,suction.Once found,timely treatment is important.Mild cyanosis can spontaneous remission,cyanosis having oxygen can not be sustained remission.The prognosis of it by thoracic puncture exhaust or closed thoracic drainage is good.Actively control influence during pregnancy,birth and postpartum.Preventing meconium inhalation can reduce the occurrence of neonatal pneumonia complicated with pneumothorax.

关 键 词：肺炎 气胸 胸腔穿刺 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]