胸部X线对肺透明膜病病情程度的监测

目的 评价X线对肺表面活性物质(PS)固尔苏治疗肺透明膜病(HMD)的疗效监测.方法 回顾确诊为Ⅲ～Ⅳ级HMD、应用PS治疗的早产儿21例病例,采用用药后1/2 h、6 h、24 h、48 h、5 d胸片观察.结果 用药后1/2 h胸片双肺透亮度即有改善15例;肺部表现进行性改善,较前次朐片好转16例;病变无改变或进展5例,其中并发肺出血1例,出现气漏3例;伴有肺部炎症样改变3例;动脉导管开放(PDA)11例.结论 使用PS治疗后胸片动态观察能对Ⅲ～Ⅳ级HMD病变转归作出正确判断,短期复查能及时发现HMD并发症.

A dynamic observation of the X-ray images in chest after applying cnrosurf to hyaline membrane disease in grade Ⅲ～Ⅳ of the premature infants' lungs

Objective To analyze the characteristics of the dynamic changes of the radiological X-ray images in chest after applying a pulmonary surfactant(PS) named curosurf to hyaline membrane disease in grade Ⅲ～Ⅳ of the premature lungs,and to study the clinical values of the follow-ups with chest films after applying PS to evaluate its effects and to detect the complications in chest. Methods To review the definite cases of HMD in grade Ⅲ～Ⅳ with final clinical and radiological diagnosis so as to analyze the radiological image manifestations in ehest after applying PS to the premature lungs for half an hour, for 6 hours,for 24 hours, for 48 hours and for 5 days. Results Shortly after the application of PS,according to the chest films,just half an hour later, 15 cases improved their degrees of the transmittance of the two lungs; 16 cases progressively ameliorated their manifestations in chest, taking the turn for the better than the previous images; 5 cases had no improvement, among which 1 developed a complication of pulmonary hemorrhage,and 3 developed pulmonary air leakage; 3 eases accompanied with pulmonary inflammation-like lesions; 11 cases presented patent arterial duets(PDA). Generally speaking, the X-ray image manifestation was the same as the clinical symptoms. Conclusion A dynamic observation of the X-ray films in chest after the application of PS is able to make a correct iudgement of the lesions of HMD in grade Ⅲ～Ⅳ,and can promptly detect its complications if taking a short-term review.