CAJ | 학술논문

目的探讨早产儿与足月儿气胸的临床特点。方法选择2008年1月至2012年12月在四川大学华西第二医院新生儿科住院治疗的166例气胸患儿为研究对象,按照出生时胎龄将其分为早产儿组(42例,胎龄<37孕周)和足月儿组(124例,37孕周≤胎龄<42孕周)。回顾性分析并比较两组患儿的临床表现、治疗及结局。本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人知情同意,并与监护人签署临床研究知情同意书。结果①两组患儿入院时性别及生产方式构成比比较,差异均无统计学意义(P>0.05),两组均为男性多于女性、剖宫产多于自然分娩。②早产儿组出生体质量、胎龄及入院年龄均较足月儿组低,且差异均有统计学意义(P<0.05)。③早产儿组入院时发现气胸比例显著低于足月儿组,且差异有统计学意义(P<0.05)。④早产儿组与足月儿组气胸类型构成比比较,差异有统计学意义(P<0.05),早产儿组病理性和(或)医源性气胸所占比例更大,而足月儿组自发性气胸所占比例更大。⑤早产儿组胸腔闭式引流率、机械通气率、病死率、所有患儿平均住院日及治愈患儿平均住院日均显著高于或长于足月儿组,且差异均有统计学意义(P<0.05)。结论早产儿气胸病情较足月儿更危重,治疗更困难,结局更差,需临床医师高度重视。
목적탐토조산인여족월인기흉적림상특점。방법선택2008년1월지2012년12월재사천대학화서제이의원신생인과주원치료적166례기흉환인위연구대상,안조출생시태령장기분위조산인조(42례,태령<37잉주)화족월인조(124례,37잉주≤태령<42잉주)。회고성분석병비교량조환인적림상표현、치료급결국。본연구준순적정서부합사천대학화서제이의원인체시험위원회제정적윤리학표준,득도해위원회비준,정득수시대상감호인지정동의,병여감호인첨서림상연구지정동의서。결과①량조환인입원시성별급생산방식구성비비교,차이균무통계학의의(P>0.05),량조균위남성다우녀성、부궁산다우자연분면。②조산인조출생체질량、태령급입원년령균교족월인조저,차차이균유통계학의의(P<0.05)。③조산인조입원시발현기흉비례현저저우족월인조,차차이유통계학의의(P<0.05)。④조산인조여족월인조기흉류형구성비비교,차이유통계학의의(P<0.05),조산인조병이성화(혹)의원성기흉소점비례경대,이족월인조자발성기흉소점비례경대。⑤조산인조흉강폐식인류솔、궤계통기솔、병사솔、소유환인평균주원일급치유환인평균주원일균현저고우혹장우족월인조,차차이균유통계학의의(P<0.05)。결론조산인기흉병정교족월인경위중,치료경곤난,결국경차,수림상의사고도중시。
Objective To analyze clinical characteristics of pneumothorax in premature and mature infants.Methods A total of 1 6 6 cases of neonatal pneumothorax who got hospitalization and treatment in Department of Neonatology,West China Second University Hospital from January 2008 to December 2012 were chosen as study subj ects.According to gestational age at birth,they were divided into premature group 42 cases,gestational age<37 weeks)and mature group 124 cases,37 weeks≤gestational age<42 weeks). The clinical manifestations,treatments and outcomes were retrospectively analyzed and compared.The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of West China Second University Hospital.Informed consent was obtained from the parents of each participating patient. Results ① The constituent ratio of gender and delivery ways of two groups had no significant differences (P>0.05),the number of boys were more than the number of girls ,and the number of cesarean delivery were more than those natural labor delivery in two groups.② The birth weight,gestational age and admission age to hospital of premature group were significantly lower than those of mature group,and there were statistically significant differences (P<0.05 ).③ The incidence of pneumothorax on admission of premature group were significantly lower than that of mature group,and there was statistically significant difference(P<0.05 ).④ The constituent ratio of pneumothorax types of two groups had significant differences(P<0.05),showed more pathological and(or)iatrogenic pneumothorax in premature group and more spontaneous pneumothorax in mature group.⑤ The ratio of closed drainage of thoracic cavity and mechanical breath support,case fatality ratio,average days stay in hospital of all children and cured children of premature group were higher or longer than those of mature group,and there were statistically significant differences(P<0.05).Conclusions Compare pneumothorax in premature infants to mature infants,the patient′s conditions were more critical,treatments were more difficult and outcomes were worse.Clinicians should pay extremely more attention to pneumothorax in premature infants.