新生儿肺透明膜病X线病理对照观察

目的：研究新生儿肺透明膜病的Ｘ线表现及其动态变化。方法：经尸检病理证实的新生儿肺透明膜病１６例。男１２ 例，女４例，早产１２ 例，足月４ 例。１６例均为低体重儿。平均日龄３８ ｈ。顺产９例，剖腹产７例。１６ 例中ＣＰＡＰ治疗１０例。每例摄胸部Ｘ线片２～５次。Ｘ线表现与病理结果对照观察分析。结果：病理镜下弥漫性肺泡和终末气道内透明膜形成１１例，局限两肺下叶３例，单独右下叶１例，右下叶并左上叶１例。合并肺出血１０ 例，ＰＤＡ１３例。Ｘ线表现白肺２ 例，肺野透光度减低１１ 例。细颗粒状影１０ 例，云絮状影８例，支气管充气征１２例，纵隔积气和气胸各１例。结论：细网粒影伴支气管充气征是新生儿肺透明膜病的典型Ｘ线表现。Ｘ线随访中出现云絮状影是本病合并肺出血的重要征象。

X-ray-Pathological Comparative Observation of Neonatal Pulmonary Hyaline Membrane Disease

Objective:To study the radiologic manifestations and its dynamic changings of neonatal pulmonary hyaline membrane disease(NFFMD).Methods:16 cases of NPHMD were proved by autopsy.There were 12 men and 4 women,all of the cases were lower birth weight.Prematurity was in 12,term was in 4,average age was 38 hours.9 cases were normal delivery,7 were abdominal delivery,10 cases were treated with CPAF,all of cases were followed up with chest roentgenogram 2 to 5 times.Radiologic and pathologic findings were compared and analysed.Results:Pathology showed diffuse pulmonary hyaline membrane formed in the alveolus and endo-airways in 11 cases ,located at both lower lungs in 3 cases,at right lower lung in 1 case,coexited right lower and left upper lungs in 1 caes.Complicated pulmonary hemorrhage was in 10,PDA was in 13.X-ray findings included the "whit lungs"in 2,decreased translucency of the lung fields in 11,granuliform in 10,cloudy patches in 8,air-bronchograms in 12,pneumothorax in 1 and pneumomedistinum in 1.Conclusion:The shadows of fine granulations associated with air-bronchograms are the typical X-ray manifestations of MPHND,while the patch shadows are the important sign of pulmonary hemorrhage.