早产儿和足月儿先天性乳糜胸的临床特点比较  

Comparison of the clinical characteristics of congenital chylothorax in preterm and term infants

作　　者：杨常栓 彭健茹 池婧涵 朱丽敏 孔祥永 Yang Changshuan;Peng Jianru;Chi Jinghan;Zhu Limin;Kong Xiangyong(Department of Neonatology,Department of Pediatrics,The Seventh Medical Center of Chinese PLA General Hospital,Beijing 100700,China)

机构地区：[1]中国人民解放军总医院第七医学中心儿科医学部新生儿科,北京100700

出　　处：《中华新生儿科杂志（中英文）》2021年第4期12-16,共5页Chinese Journal of Neonatology

摘　　要：目的比较早产儿和足月儿先天性乳糜胸的临床特点。方法回顾性分析中国人民解放军总医院第七医学中心儿科医学部2011年1月至2019年12月收治的先天性乳糜胸患儿临床资料,并按照胎龄分成早产儿组(<37周)和足月儿组(≥37周),比较两组患儿一般资料、临床表现、实验室检查结果、治疗方式及预后。结果共纳入34例先天性乳糜胸患儿,其中早产儿组11例,足月儿组23例。两组性别、分娩方式、产前诊断胸腔积液比例、伴有先天性心脏病/染色体异常、出生时窒息、呼吸困难、胎儿水肿、积液产生部位等方面差异均无统计学意义(P>0.05)。早产儿组胸水白细胞计数和蛋白含量均低于足月儿组[3245(1007,7403)×10^(6)/L比10214(6233,16458)×10^(6)/L,(28.1±7.6)g/L比(33.3±6.3)g/L],差异有统计学意义(P<0.05);两组胸水淋巴细胞比例差异无统计学意义(P>0.05)。早产儿组机械通气比例高于足月儿组[100%(11/11)比65.2%(15/23)],机械通气时间长于足月儿组[(16(10,25)d)比(1(0,11)d)],差异有统计学意义(P<0.05);两组其他治疗方式(穿刺/引流、禁食、加用奥曲肽及红霉素胸腔注入)、积液消失时间、住院时间和治愈/好转率等方面差异无统计学意义(P>0.05)。结论早产儿胸水白细胞计数和蛋白含量低于足月儿,早产儿和足月儿胸水淋巴细胞比例均较高。尽管早产儿生后多需呼吸机支持,但预后良好,同足月儿无显著差异,多数经保守治疗痊愈。Objective To compare the clinical characteristics of congenital chylothorax in preterm and term infants.Method From January 2011 to December 2019,the clinical data of infants with congenital chylothorax admitted to our hospital were retrospectively analyzed.The infants were assigned into preterm group(<37 weeks)and term group(≥37 weeks)according to their gestational age.The general information,clinical manifestations,laboratory results,treatment and prognosis of the two groups were compared.Result A total of 34 infants with congenital chylothorax were included,including 11 premature infants and 23 term infants.No significant differences existed in gender,delivery mode,prenatal diagnosis of pleural effusion,congenital heart disease/chromosome abnormality,birth asphyxia,dyspnea,fetal edema,and location of effusion between the two groups(P>0.05).Compared with term group,preterm group had significantly fewer leukocytes[3245(1007,7403)×10^(6)/L vs.10214(6233,16458)×10^(6)/L]and lower protein level[(28.1±7.6)g/L vs.(33.3±6.3)g/L]in the pleural fluid(P<0.05).No significant differences existed in the proportion of pleural lymphocytes between the two groups(P>0.05).The proportion of mechanical ventilation(MV)in the preterm group was statistically higher than that the term group[100%(11/11)vs.65.2%(15/23)],and the duration of MV was statistically longer than the term group[(16(10,25)d)vs.(1(0,11)d)](P<0.05).No significant differences existed between the two groups in the application of other treatment options(thoracentesis/drainage,fasting,octreotide and erythromycin pleural injection),time needed for the disappearance of effusion,duration of hospital stay and cure/improvement rate(P>0.05).Conclusion Preterm infants may have lower leukocyte count and protein level in the pleural effusion than the term infants.Both preterm and term infants have higher proportion of lymphocytes in the pleural effusion fluid.Although most preterm infants need ventilator support after delivery,most of them achieve complete remission afte

关 键 词：乳糜胸 婴儿 早产 足月分娩 先天性 

分 类 号：R722.6[医药卫生—儿科] R722.1[医药卫生—临床医学]