新生儿肺透明膜病及其并发症的临床和X线诊断(附50例分析)

目的:通过分析新生儿肺透明膜病(HMD)及其并发症的临床和X线表现,提高对该病X线征象的认识。方法:对确诊HMD 50例患儿的临床表现、X线及部分病理资料作回顾性分析,所有病例均作了胸腹部照片检查。除3例重症患儿当天死亡外,其余均作了2~5次不等照片检查。结果:轻度13例,X线表现为两肺内中带网点状和(或)细颗粒状增密影;中度25例,X线表现为两肺细小颗粒影逐渐融合成片,肺透过度降低,支气管充气征广泛;重度12例,两肺实变呈"白肺"状,心缘、膈面完全消失,支气管充气征明显或消失。结论:新生儿肺透明膜病的X线表现有其特征性,X线照片动态观察不但可明确诊断,同时能及时发现各种并发症,及早诊断,对治疗和预后评估具有重要意义。

Clinical and x-ray diagnosis of neonatal hyaline membrane disesae and its complication:a report of 50 cases

Objective To analyze the clinical and x- ray appearance of neonatal hyaline membrane disease （HMD） and its complication, and improve the cognition of its x - ray appearance. Method The clinical and x - ray appearance and partial pathological data of 50 cases who were finally diagnosed of HMD were analyzed. All the cases took photographs of thoracic and abdominal part. Three severe eases died that day, others took photographs for 2 -5 times. Results Thirteen cases were lower grade, reticulonodular or granular densities were found in two lungs＇ inside and intermediate band in x -ray appearance;25 cases were midrange,the x- ray appearance was that the small granular shadow of two lungs coalesced as lamellar gradually. The lungs＇ light transmission degraded. Aerate sign of bronchi was extensive; 12 were severe, consol was found in the two lungs as white lung, the borderline of heart and plane of diaphragm disappear soundly,the aerate sign of bronchi was obvious or disappear. Dynamic viewing in x - ray：x - ray appearance of 10 cases graded, 37 improved in different de- gree. Conclusion The x - ray appearance of neonatal hyaline membrane disease has mark. Dynamic viewing in x - ray can identify diagnosis and find complication in time and diagnose early. It is significant to therapy and appraisal of prognosis.