新生儿气胸43例临床观察.doc

新生儿气胸43例临床观察[摘要] 目的：探讨新生儿气胸的病因及治疗方法。方法：43例气胸患儿中12例给予镇静、面罩吸氧等保守治疗；31例先行患侧胸腔穿刺抽气治疗后，6例行胸腔闭式引流术治疗。结果：43例气胸患儿，痊愈出院39例，死亡3例，自动出院1例。6例患儿行胸腔闭式引流术，胸腔闭式引流时间平均5~10 d，胸液引流量为0~150 ml，均顺利拔除胸腔闭式引流管。结论：胸腔穿刺抽气及胸腔闭式引流术是治疗新生儿气胸的有效措施，应根据肺压缩体积大小、临床表现以及血气分析结果选择合适的治疗方案。 [关键词] 新生儿气胸；胸腔闭式引流；机械通气；临床观察 [中图分类号] R725.6 [文献标识码]C [文章编号]1674-4721（2011）08（a）-188-02 Clinical observation of 43 newborns with pneumothorax KONG Yuxian Department of Pediatrics, the People’s Hospital of Puyang, Henan Province, Puyang 457000, China [Abstract] Objective: To investigate the cause and treatment of pneumothorax in newborn. Methods: 43 newborns with pneumothorax were selected. 12 cases were treated with sedatives, oxygen masks and other conservative therapy; 31 cases had pumping decompression by pleural puncture, after which 6 cases had closed thoractic drainage. Results: After the treatment, 39 cases were cured and 1 case was automatically discharged, while 3 cases were dead. The results of 6 cases which had closed thoractic drainage showed that the mean duration of drainage ranged from 5 to 10 d, the drainage amount was from 0 to 150 ml, and closed thoractic drainage tubes were all removed successfully. Conclusion: Pumping decompression by pleural puncture and closed thoractic drainage are the effective measures in the treatment of pneumothorax in newborn. Appropriate treatment should be chosen based on lung compression degree, clinical manifestation and results of blood gas analysis. [Key words] Newborn pneumothorax; Closed thoracic drainage; Mechanical ventilation; Respiratory Complications 新生儿气胸是新生儿期呼吸系统严重并发症，为新生儿科常见的急症之一[1]。如若不能及时诊治，便可危及生命。2008年1月~2010年5月本科共收治新生儿气胸43例，报道如下： 1 资料与方法 1.1 一般资料 选择2008年1月～2010年5月在本科收治的新生儿气胸43例，其中，男25例，女18例；足月儿26例，早产儿15例，过期产儿2例；自发性气胸16例，均无明显肺部疾病及心肺复苏等有关医源性或病理性因素；病理性气胸21例，其中宫内窘迫伴出生时窒息9例，胎粪吸入5例，肺透明膜病2例，新生儿肺炎3例，新生儿败血症2例；医源性气胸6例，其中3例出生时有窒息抢救史，2例应用NCPAP，3例为应用机械通气所致。 1.2 治疗方法 根据血气分析结果、X线胸片肺体积压缩大小以及临床表现选择最佳的治疗方案。其中12例给予镇静、面罩吸氧等保守治疗；31例行患侧胸腔穿刺抽气治