CAJ | 학술논문

目的:探讨新生儿呼吸窘迫综合征(NRDS)并发支气管肺发育不良(BPD)影像学表现及其意义,以提高对该并发症的胸部影像的认识,尤其是该并发症的早期胸部影像的认识.方法:选择2006年1月-2011年11月本院新生儿科收治的符合研究条件的新生儿呼吸窘迫综合征并发支气管肺发育不良(BPD)66例患儿,随访2年,出院诊断明确,有完整胸部影像资料和完整临床资料的病例,进行回顾分析.结果:本组NRDS治疗后并发BPD 66例,治疗过程中平均治疗2~3周后复查影像检查,几乎所有并发BPD患儿胸片均开始出现“两肺透亮度减低,呈‘磨玻璃’样改变,两肺野可见斑片及云絮状阴影,边界模糊不清”表现,而且治疗过程中该影像较肺水肿影像持续时间长、吸收相对较慢.66例最终均出现不同程度的网格状囊泡状阴影改变,25例此后连续拍片影像无明显变化.结论:胸部影像是临床动态观察病情变化最直观、最方便、最快捷的首先方法,新生儿支气管肺发育不良的诊断主要根据临床病史及影像学资料,胸片、CT表现虽无特征性,但具有诊断意义,尤其是高分辨率CT能提供更多有价值的征象,有助于BPD的早期诊断,为临床及患儿尽早预防治疗赢得时间.
목적:탐토신생인호흡군박종합정(NRDS)병발지기관폐발육불량(BPD)영상학표현급기의의,이제고대해병발증적흉부영상적인식,우기시해병발증적조기흉부영상적인식.방법:선택2006년1월-2011년11월본원신생인과수치적부합연구조건적신생인호흡군박종합정병발지기관폐발육불량(BPD)66례환인,수방2년,출원진단명학,유완정흉부영상자료화완정림상자료적병례,진행회고분석.결과:본조NRDS치료후병발BPD 66례,치료과정중평균치료2~3주후복사영상검사,궤호소유병발BPD환인흉편균개시출현“량폐투량도감저,정‘마파리’양개변,량폐야가견반편급운서상음영,변계모호불청”표현,이차치료과정중해영상교폐수종영상지속시간장、흡수상대교만.66례최종균출현불동정도적망격상낭포상음영개변,25례차후련속박편영상무명현변화.결론:흉부영상시림상동태관찰병정변화최직관、최방편、최쾌첩적수선방법,신생인지기관폐발육불량적진단주요근거림상병사급영상학자료,흉편、CT표현수무특정성,단구유진단의의,우기시고분변솔CT능제공경다유개치적정상,유조우BPD적조기진단,위림상급환인진조예방치료영득시간.
Objective:To investigate the imaging findings and significance of neonatal respiratory distress syndrome(NRDS)complicated with bronchopulmonary dysplasia(BPD),and improve the understandings of complication of chest images especially the early chest images. Method:66 newborns with neonatal respiratory distress syndrome complicated with bronchopulmonary dysplasia(BPD)admitted in the hospital from January 2006 to November 2011 were involved in this research. These cases who had clear discharge diagnosis,full chest image data and complete clinical data and followed for 2 years were analyzed retrospectively. Result:Review of imaging after average treatment for 2-3 weeks showed that 66 cases who treated with NRDS complicated with BPD all showed lungs brightness reduction,ground glass visible changes,planes and flocculent cloud shadow patches of both lung fields and blurred boundary performance. Furthermore,absorption was relatively slower and lasting time was relatively longer compared with image of pulmonary edema during the treatment. 66 cases ultimately had varied degrees of grid-like vesicle-like shadow of change and 25 cases had no significant change after continuous film image. Conclusion:Chest radiographic image change is the most intuitive,most convenient,fastest and first method of clinical dynamic observation. Diagnosis of neonatal bronchopulmonary dysplasia is mainly according on clinical history and imaging data. Although image of chest radiograph and CT has no significantly character,it is very important for the diagnosis. The high resolution CT can provide some valuable signs which contribute to the early diagnosis of development of BPD and gain important time for the prevention and treatment of patients.