1例极低出生体重儿多次肺出血报道并文献复习  

A case of very low birth weight infant with multiple episodes of pulmonary and a literature review

作　　者：何晓青 郭育屏 姜舟 HE Xiaoqing;GUO Yuping;JIANG Zhou(Department of Neonatology,Shaoyifu Hospital Affiliated to Zhejiang University School of Medicine,Zhejiang Province,Hangzhou 310000,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院新生儿科,浙江杭州310000

出　　处：《妇儿健康导刊》2025年第3期65-68,共4页JOURNAL OF WOMEN AND CHILDREN'S HEALTH GUIDE

摘　　要：在早产极低出生体重儿(VLBWI)中,肺出血多发生于出生后3~4d,是临床较为多见的急危重症之一,其进展快,病死率高,严重威胁患儿的生命安全。本文报道1例出生后2周连续3次发生肺出血的早产VLBWI,为临床VLBWI多次肺出血的诊疗提供参考。该患儿接受肺表面活性物质、经鼻持续气道正压通气、呼吸机、气道内止血、抗感染、强心治疗等多种干预,病情恢复稳定;在排除感染性疾病、肺源性疾病等常见因素后,心脏彩超虽未发现心肌异常,但强心治疗有效,推测与心源性因素相关;遗传病基因检测提示MYH6杂合变异,明确为基因突变导致的肺出血。In very low birth weight infants(VLBWI),pulmonary hemorrhage usually occurs 3-4 days after birth,which is one of the most common acute and critical diseases in clinical practice,with rapid progression and high mortality,seriously threatening the life safety of infants.This paper reports a case of premature VLBWI with pulmonary hemorrhage for 3 consecutive times at 2 weeks after birth,to provide reference for diagnosis and treatment of multiple pulmonary hemorrhage in VLBWI.The infant was treated with pulmonary surfactant,nasal continuous positive airway pressure ventilation,ventilator,intra-airway hemostasis,anti-infection,cardiac therapy and other interventions,and her condition recovered to stability.After the exclusion of infectious diseases,pulmonary diseases and other common factors,although myocardial abnormalities were not found,the cardiotonic treatment was effective,which is presumed to be related to cardiogenic factors.The genetic test of genetic disease indicated MYH6 heterozygous mutation,which was clearly the pulmonary hemorrhage caused by gene mutation.

关 键 词：极低出生体重儿 早产儿 肺出血 MYH6杂合变异 

分 类 号：R722.1[医药卫生—儿科]