外源性肺泡表面活性物质治疗新生儿呼吸窘迫综合征后胸部X线表现  

X-ray manifestations of neonatal respiratory distress syndrome after treatment with exogenous pulmonary surfactant

作　　者：陈荟竹[1] 宁刚[1] 

机构地区：[1]四川大学华西第二医院放射科,成都610041

出　　处：《放射学实践》2014年第12期1415-1419,共5页Radiologic Practice

摘　　要：目的：探讨新生儿呼吸窘迫综合征（NRDS）患儿在外源性肺泡表面活性物质（PS）治疗前后胸部 X 线表现及其临床应用价值。方法：经临床和影像学检查诊断为 NRDS 的58例患儿使用肺泡表面活性物质进行治疗，分析用药前后患儿的胸部 X 线表现及变化规律。结果：58例患儿首次拍片的诊断结果：NRDS Ⅰ级13例（22％），Ⅱ级25例（43％），Ⅲ级13例（22％），Ⅳ级7例（13％）；PS 治疗后2～72 h 第1次复查胸片，示双肺透亮度较前增高48例，降低5例，增高且伴有纵隔和（或）肺间质积气4例；19例进行第2次复查胸片，显示双肺内恢复正常3例，新生儿肺炎15例，新生儿肺炎并纵隔、肺间质积气1例；11例第3次复查胸片，显示双肺内恢复正常3例，肺炎7例，新生儿肺炎并纵隔、间质积气1例；1例第4次复查胸片，示支气管肺发育不良。胸片显示气管插管位置异常10例。结论：X 线检查可用于评价外源性肺泡表面活性物质治疗 NRDS 的疗效，了解气管插管的位置，并能早期发现肺炎、纵隔和肺间质积气等并发症。Objectire：To investigate X-ray findings of neonatal respiratory distress syndrome （NRDS）before and af-ter treatment with exogenous pulmonary surfactant （EPS）and its clinical value.Methods：58 patients with neonatal respira-tory distress syndrome treated with exogenous pulmonary surfactant were diagnosed by clinical and radiology,the X-ray findings and changes on chest film before and after treatment were analyzed retrospectively.Results：Before treatment,the results of the first X-ray film in 58 cases：NRDS grade Ⅰ in 13 cases （22%）,NRDS grade Ⅱ in 25 cases （43%）,NRDS grade Ⅲ in 13 cases （22%）,NRDS grade Ⅳ in 7 cases （13%）.All cases underwent the first X-ray reexamination 2 ～72 hours after treatment,the transparency of lung increased in 48 cases,decreased in 5 cases,increased with pneumomediasti-num and pulmonary interstitial pneumatosis in 4 cases.19 cases underwent the second X-ray reexamination,the lung was showed normal in 3 cases,pneumonia in 15 cases,pulmonary interstitial pneumatosis in 1 case.On the chest film of the third follow-up examination,the lung had normal findings in 3 cases,pneumonia in 7 cases,pulmonary interstitial pneumatosis in 1 case.Only one case underwent the fourth follow-up examination,and showed bronchopulmonary dysplasia.Abnormal posi-tion of endotracheal intubation was showed in 10 cases.Conclusion：X-ray examination is helpful not only to evaluation of the treatment effect of EPS for NRDS,and the position of endotracheal intubation,but also to early detection of the compli-cations including pneumonia,pneumomediastinum and pulmonary interstitial emphysema.

关 键 词：新生儿 呼吸窘迫综合征 肺泡表面活性物质 放射摄影术 

分 类 号：R722.1[医药卫生—儿科] R816.92[医药卫生—临床医学]