【新生儿肺透明膜病X线片与CT诊断对照分析】新生儿做ct看肺发育情况
[摘要] 目的 对新生儿肺透明膜病X线片和CT诊断结果进行比较分析，并探讨其应用。 方法 选取2009年11月～2011年11月于我院诊治的新生儿肺透明膜病患儿50例，对照其临床治疗过程中的X线片与CT影像学资料，观察分析诊断结果。 结果 新生儿肺透明膜病的典型病症包括胸片表现的细颗粒状、网格状、支气管充气征以及两肺野透亮度减低等，并发症包括肺出血、肺炎和气胸等。分析表明，肺部病变检出率CT扫描与X线片二者比较差异有高度统计学意义（P < 0.01）；并发症检出率CT扫描与X线片二者比较差异有统计学意义（P < 0.05）。 结论 X线片与CT对新生儿肺透明膜病的诊断是相互补充的，对临床高度可疑但X线片观察不能排除的患儿，应及时实施CT扫描，这对该疾病的鉴别诊断以及发现并发症等具有重要的指导性意义。
[关键词] 新生儿肺透明膜病；X线片；CT扫描
[中图分类号] R722 [文献标识码] B [文章编号] 1673-7210（2012）07（a）-0093-02
Comparative analysis of hyaline membrane disease with X-ray films and CT diagnosis
LIN Huayun1 LIN Yunliang2
1.Department of Radiology, Maternal and Child Health Hospital of Heyuan City, Guangdong Province, Heyuan 517000, China; 2.Department of Radiology, the People"s Hospital of Heyuan City, Guangdong Province, Heyuan 517000, China
[Abstract] Objective To compare and analyse the results of the neonatal hyaline membrane disease X-ray films and CT diagnosis and explore its applications. Methods 50 cases hyaline membrane disease children from November 2009 to November 2011 in our hospital was selected, its clinical treatment in the process of X-ray film and CT imaging data was analysised, to the results of the diagnosis were observed and analyzed. Results Neonatal hyaline membrane disease typical symptoms, including chest X-ray performance of fine granular grid, air bronchogram, and two lung fields through the brightness to reduce and so on. The complications include pulmonary hemorrhage, pneumonia and pneumothorax. The analysis showed that the lung lesion detection rate of CT scan and X-ray film contrast the two was statistically significant (P < 0.01). Contrasted CT scan and X-ray film detection rate of complications, and the difference was statistically significant (P < 0.05). Conclusion X-ray films and CT complement each other hyaline membrane disease diagnosis, highly suspicious of clinical X-ray film observation can not be ruled out in children, the differential diagnosis of the disease and the discovery of complications has important guiding significance.
[Key words] Hyaline membrane disease; X-ray film; CT scans
新生儿肺透明膜病（HMD）又称为新生儿呼吸窘迫综合征（NRDS），指出生后不久即出现进行性呼吸困难、呼气性呻吟、呼吸衰竭和吸气性三凹征等，是一种死亡率很高的新生儿疾病，常见于因肺表面活性物质不足导致进行性肺不张的早产儿[1]。其病理特征为肺泡壁至终末细支气管壁上附有嗜伊红透明膜，导致各系统疾患继发，病程发展迅速[2]。因此早期诊断并迅速施治是降低死亡率的关键，胸部X线平片与CT扫描对诊断此病有重要意义。本文将重点比较分析X线片与CT扫描两种方式对HMD的诊断，现将结果报道如下：
1 资料与方法
1.1 一般资料
选取河源市妇幼保健院2009年11月～2011年11月临床诊治的HMD患儿50例，其中，男28例，女22例，时龄30 min～24 h，平均（8.5±1.5）h。其中，26～36周分娩 32例，36～42 周分娩8例，≥35周剖宫产10例；个体体重900～2 500 g，平均体重1 700 g；自然分娩40例，剖宫产10例；产妇当中，5例有糖尿病，14例患有妊娠高血压综合征。