Bick U, Müller-Leisse C, Tröger J, Jorch G, Roos N, Meyer zu Wendischhoff J, Flothmann U, Kachel W, Lemburg P, Linderkamp O
Department of Radiology, University of Münster, FRG.
Pediatr Radiol. 1992;22(3):169-73. doi: 10.1007/BF02012487.
As part of a multicenter surfactant rescue study, the chest X-rays of 239 preterm and term infants were analyzed. To study the influence of surfactant administration on radiographic appearance, 130 patients with a clinical and radiological diagnosis of typical respiratory distress syndrome were selected, in whom adequate chest x-rays before and within 48 h after treatment were available. Median gestational age was 30 weeks (range 25-38 weeks), median birth weight was 1335 g (range 625-3450). The time of surfactant application ranged between 90 min and 24 h after birth (median 6 h). The most common finding after surfactant administration was uniform (n = 47) or disproportionate (n = 46) improvement of pulmonary aeration, which showed a significant correlation to posttreatment reduction of oxygen requirement (p less than 0.0001). Asymmetric clearance was more often localized on the right side and usually disappeared within two to five days. Only in 13 patients no change of ventilation was found. Development of interstitial emphysema (n = 24, including three patients with pneumothorax) after surfactant treatment was an unfavourable prognostic sign. 54% of these patients (13 of 24) died within the first month of life, compared to 8% (7 of 93) in the group of patients with initial improvement of ventilation.
作为一项多中心表面活性剂抢救研究的一部分，对239例早产和足月婴儿的胸部X光片进行了分析。为研究表面活性剂给药对影像学表现的影响，选择了130例临床和放射学诊断为典型呼吸窘迫综合征的患者，这些患者在治疗前和治疗后48小时内有足够的胸部X光片。中位胎龄为30周（范围25 - 38周），中位出生体重为1335克（范围625 - 3450克）。表面活性剂应用时间在出生后90分钟至24小时之间（中位时间为6小时）。表面活性剂给药后最常见的表现是肺部通气均匀（n = 47）或不成比例（n = 46）改善，这与治疗后氧需求降低显著相关（p小于0.0001）。不对称清除更常出现在右侧，通常在两到五天内消失。仅13例患者通气无变化。表面活性剂治疗后发生间质性肺气肿（n = 24，包括3例气胸患者）是不良预后征象。这些患者中有54%（24例中的13例）在出生后第一个月内死亡，而通气最初改善的患者组中这一比例为8%（93例中的7例）。
