新生儿气胸32例临床分析.doc

新生儿气胸32例临床分析 　摘 要 目的：探讨新生儿气胸发生的原因、特点及防治方法。方法：回顾性分析2014年1月”2015年12月新生儿重症监护病房收治的32例气胸患儿的临床资料，其中右侧气胸16例，左侧气胸10例，双侧气胸6例。18例采用保守治疗，1例采用肺表面活性物质联合常频机械通气治疗，13例行胸腔闭式引流治疗。结果：自发性气胸2例，病理性气胸30例，其中胎粪吸入综合征7例，呼吸窘迫综合征10例，肺炎8例，湿肺5例。治愈30例，死亡2例。结论：提倡无剖宫产指证的自然分娩，可减少出生时窒息的发生。应用肺保护性通气策略的机械通气模式结合胸腔闭式引流对气胸的治疗效果较好。　　关键词 气胸 病因 新生儿 防治　　中图分类号：R722.1 文献标志码：A 文章编号：1006-1533（2016）18-0034-02　　Clinical analysis of thirty-two cases of neonatal pneumothorax　　PENG Bin， XI Kangming　　（Department of Neonatology， First peoples Hospital of Bengbu City， Anhui Province 233000， China）　　ABSTRACT Objective： To investigate the causes， characteristics and prevention of pneumothorax in newborn. Methods： The clinical data of 32 cases of pneumothorax in the neonatal intensive care unit from January 2014 to December 2015 were retrospectively analyzed， of whom 16 cases had right pneumothorax， 10 cases left pneumothorax， and 6 cases bilateral pneumothorax. Eighteen cases were treated with the conservative treatment， 1 cases with pulmonary surfactant combined with conventional mechanical ventilation treatment， and 13 cases with thoracic closed drainage treatment. Results： There were 2 cases with spontaneous pneumothorax and 30 cases of pathological pneumothorax， among of them 7 cases had meconium aspiration syndrome， 10 cases respiratory distress syndrome， 8 cases pneumonia and 5 cases wet lung. Thirty cases were cured and 2 cases died. Conclusion： Advocating natural delivery without the cesarean section indication can reduce the occurrence of birth asphyxia. Mechanical ventilation mode with lung protective ventilation strategy combined with thoracic closed drainage is effective in the treatment of pneumothorax.　　KEY WORDS pneumothorax； pathogeny； neonate； prevention and treatment　　新生儿气胸是引起新生儿气漏综合征的重要疾病之一，是新生儿重症监护室（NICU）的危重病，发病率为1%～2%[1]，起病急，进展快，病死率高。如能预防气胸的发生或及早诊断和处理可降低患儿病死率，提高存活率。本文回顾分析我院NICU收治的32例气胸患儿的临床资料，总结发病原因和临床特点，以寻求有效的防治措施。　　1 资料与方法　　1.1 一般资料　　收集我院NICU2014年1月-2015年12月收治的32例气胸患儿，诊断均符合《实用新生儿学》[2]中新生儿气胸的标准，其中男27例，女