新生儿气胸91例临床研究.docxVIP

新生儿气胸91例临床研究 【摘要】目的：研究新生儿气胸常见发病原因、 临床表现、防治及预后。方法：回顾性分析本院2007年1 月-2012年12月诊断新生儿气胸的91例患儿临床资料，对 所搜集病例的临床资料进行统计分析。结果：在91例临床 病例中，按气胸类型分类，自发性气胸23例（25. 3%）,继 发性气胸68例（74. 7%）；男女比例为52： 39,平均出生体 重2515. 7 g；继发性气胸及自发性气胸患儿胎龄构成之间存 在差异（P=0.002）；单侧气胸比例高于双侧气胸（80. 2% vs 19. 8%）o继发性气胸中胎粪吸入比例最髙；两种类型气胸的 临床治疗方式上存在不同（P=0.026）。继发性气胸需要更强 有力的治疗，包括镇静吸氧、穿刺负压吸引、机械通气等手 段；最终好转80例（87.9%）,死亡7例（7.7%）,自动出院 4例，两组患儿死亡率之间差异无统计学意义（P0.05）。结 论：新生儿气胸仍不少见，继发性气胸尤其是医源性操作因 素仍占较大比例，需要医生提高临床操作规范，尽量避免医 源性伤害。 【关键词】新生儿；气胸；临床表现 Clinical Analysis of 91 Cases of Newborn Pneumothorax/YAO Hai-juan , SUN Bin. //Medical Innovation of China, 2013, 10 （35）： 091-094 [Abstract] Objective： To investigate the common cause ， clinical manifestation , prevention and prognosis of newborn pneumothorax? Method： Ninety-one cases of pneumothorax neonates hospitalized from January 2007 to December 2012 were analyzed retrospectively. Result: There were 23 spontaneous pneumothorax cases (25. 3%)，68 secondary pneumothorax cases (74. 7%) according tot he pneum ot horax type. The ratio was 52： 39 male to female, the average birthweight was 2515. 7 g； there were difference of gestation age between spontaneous and secondary pneumothorax (P二0.002) . The ratio of unilateral pneumothorax was higher than bilateral (80.2% vs 19.8% )? Among secondary pneumothorax, meconium aspiration had the highest percentage? There were differences in treatments of the two types, far stronger treatments were needed for secondary pneumothorax (P=0. 026 )? There were including sedation and oxygen inhalation , puncture and intensity vacuum aspiration, mechanical ventilation； then 80 cases improved (87.9%), 7 cases died (7. 7%), 4 cases discharged on request, there were no statistical differences in death rate between the two groups （ P〉0.05 ）? Conclusion : Newborn pneumothorax is not rare, secondary pneumothorax, especially caused by medical operation accounts for a large proportion. Doctors should develop the standard clinical manipulation, and try to avoid iatrogen