新生儿肺透明膜病的计算机X线摄影表现与临床分析

目的探讨新生儿肺透明膜病（hyaline membrane disease，HMD）的计算机X线摄影（CR）表现、分级与临床多种因素的相关性。方法回顾性分析我院2009年7月至2011年1月经临床证实HMD198例患儿的X线表现及临床资料，根据其X线表现将其分为不同等级，比较X线等级与临床多种因素的相关性。进行统计学处理。结果198例中首次胸片正常5例，x线征象有：①肺野透亮度减低；②网粒状、结节状影，融合呈“白肺”；③支气管充气征；④心缘膈面模糊；⑤小泡状透亮影与气胸征、纵隔气肿征。按胸部X线表现最严重时分Ⅰ级91例，Ⅱ级52例，Ⅲ级37例，Ⅳ级18例。有并发症129例，其中〉12种并发症63例。死亡43例。出生体重、胎龄、宫内缺氧，出生窒息、32种并发症、死亡率各与X线分级比较存在显著性差异（均P〈0．01）。结论在现有分级中，可将首次检查为正常胸片归为0分级：胸部CR检查对HMD诊治及预后的判断具有重要价值。

Clinical analysis and CR features of pulmonary hyaline membrane disease in newborns

Objective To evaluate CR features and to analyze the interrelationship of other many factors between grades and the clinical data of pulmonary hyaline membrane disease （HMD） in newborns. Methods The clinical data and image displays of 198 cases with clinically proved HMD were analyzed retrospectively with X-ray diagnostic criterion in my hospital from Jul 2009 to Jan 2011. To observe X-ray features and to divides them into different levels. To compare the interrelationship between X-ray levels and other many factors by statistical analysis. Results 5 cases of the first thoracic X-ray were normal in 198 cases of HMD. X-ray features include： ①decrease transmittance of lung field; ②reticular and spot-like high-density shadow,＂White lung＂;③air-bronchogram; ④blur of cardiac border and diaphragm;⑤lung bleeding sign.Those cases were divided into 91 cases of I grade, 52 cases of II grade, 37 cases of III grade, 18 cases of IV grade by the most serious thoracic X-ray. There were complications in 129 cases of HMD. And there were 63 cases of ≥2 kinds of complications among them. 43 cases of death. The significant differences between the X-ray grade were observed in birth weight, gestational age, fetal hypoxia/the birth suffocation, greatly in be equal to 2 kinds of complications and death rate （all P〈0.01）. Conclusion The first thoracic X-ray of HMD are classified the zero grade in existing grades. X-ray check-up plays an important role in the diagnosis of HMD and evaluationg of the prognosis.