新生儿肺透明膜病及并发症螺旋CT表现.docVIP

新生儿肺透明膜病及并发症螺旋CT表现【摘要】 目的 探讨新生儿肺透明膜病及其并发症螺旋CT表现。方法 回顾性分析经临床确诊15例新生儿肺透明膜病的CT、临床资料。结果 6例轻度,5例中度,4例重度。肺透亮度减低、肺密度增高、肺内磨玻璃影、支气管充气征是新生儿肺透明膜病有特征性的CT表现;并发气胸、胸腔积液、肺炎时分别表现为胸腔新月形积气、胸腔新月形积液、肺内斑片状影。如并发气胸、胸腔积液、肺炎时,患儿死亡率将提高。结论 螺旋CT扫描可反映病变的范围及程度,同时及时发现相关并发症,对临床治疗及评估预后具有一定意义。 【关键词】新生儿;肺透明膜病;并发症;断层摄影术 Manifestation of helical CT of newborn hyaline membrane disease and its complications JIA Xi-zhong.No.1 affiliated hospital of Nanyang Medical College,Henan Nanyang 473058,China 【Abstract】 Objective To discuss the manifestation of spiral CT of hyaline membrane disease and its complications.Methods Retrospective analysis of CT and clinical data of 10 cases of clinically confirmed hyaline membrane disease.Results 6 cases mild,Five cases moderate,4 cases severe.Reduced lung brightness,increased lung density,pulmonary ground-glass shadow and inflatable bronchia was characteristic ofhyaline membrane disease.Pneumothorax,pleural effusion,pneumonia were respectively shown as crescent plot showed pleural gas,crescent pleural effusion,pulmonary patchy shadow.The mortality rate of newborn baby will be increased if pneumothorax,pleural effusion,pneumonia was accompanied.Conclusion Spiral CT scans can reflect the scope and extent of disease,anddetect complications timely,which has significance in clinical treatment and assessment of prognosis. 【Key words】Newborn; Hyaline membrane disease; Complication; Tomography 新生儿肺透明膜病(hyaline membrane disease,HMD)又称新生儿呼吸窘迫综合征(neoratal respiratory distress syndrome,NRDS)。肺表面活性物质(pulmonary surfactant,PS)缺乏是HMD的主要原因。CT扫描有助于诊断,同时及时发现相关并发症,对临床治疗及评估预后具有一定意义。我们收集2003~2009年以来有完整CT资料的HMD 15例,总结如下。 1 材料和方法 1.1 材料 本组病例男9例,女6例。孕周≤36周6例,37周9例。生产方式:剖腹产8例,顺产7例。出生体重2350~3600 g。发病时间:生后20 min发病1例,4~6 h发病12例, HMD的病理基础主要是进行性肺泡萎陷所致的泡性肺不张、肺泡及间质水肿和毛细血管充血[2],同时肺泡壁、肺泡管及终末细支气管壁上附有一层透明膜。肺泡表面活性物质缺乏时所致进行性肺泡萎陷、肺泡不张,肺组织缺氧毛细血管通透性增高时血浆漏出、肺透明膜形成所致的肺水肿、肺实变,加之毛细血管充血,这些因素共同所致肺含气量减少、肺透亮度减低、肺密度增高、肺部磨玻璃影、支气管充气征。虽然肺泡萎陷、肺泡不张,肺水肿、肺实变,但支气管是通畅的,因此CT图像上出现支气管充气征。肺泡萎陷、肺泡不张与