新生儿气胸的床旁X线诊断和临床治疗

目的:分析新生儿气胸床旁胸片的X线表现特征和临床治疗方法,提高X线诊断水平,指导临床治疗。方法:60例新生儿气胸均摄有床旁前后仰卧位胸片,58例有1次或多次随访胸片;3例又摄前后立位胸片,10例又行胸部CT扫描。结果:胸部X线表现为少量气胸的30侧,需外科穿刺或引流术的16侧;多量气胸的49侧,需外科处理的44侧,两者比较有显著性意义,χ2=13.54,P<0.001。结论:新生儿气胸床旁前后仰卧位胸片检查基本能满足临床的要求;若以单侧肺野透亮度增强,心缘和膈面异常锐利清晰为多量气胸,则约90%需要外科处理,对指导选择治疗方法有一定帮助,可作为参考。

Bedside Radiographic Diagnosis and Clinical Treatment of Pneumothorax in Neonates

Objective To analyze radiographic characteristics of bedside chest radiographs of pneumothorax in neonates,to improve its diagnostic quality,and guide the clinical treatment.Methods Supine anteroposterior chest film at bedside was taken in 60 neonates with pneumothorax,One or more radiographic follow-ups were made in 58 cases.Of which additional anteroposterior chest film with erect position and CT scanning of chest was carried out in 3 and 10.Results Of the total 60 cases,mild pneumothorax in 30 sides,16 need surgical treatments(closed thoracic drainage or aspirated air from pneumothorax).Severe pneumothorax in 49 sides,44 need the surgical treatment.Difference between two groups were statistically significant(χ2=13.54,P<0.001).Conclusion The X-ray changes of supine A-P chest films of pneumothorax in neonates are characteristic.It basically meets the clinical requisition of pneumothorax in neonates.About 90% severe pneumothorax(that transparent of the whole affected lung field enhancement,cardiac margin and diaphragmatic surface is sharp-edged and clear)need surgical treatment.It would be useful in guiding the treatment of pneumothorax in neonates.