Hanson J B, Waldstein G, Hernandez J A, Fan L L
Department of Perinatology, Children's Hospital, Denver, CO 80218.
Am J Dis Child. 1988 Oct;142(10):1094-8. doi: 10.1001/archpedi.1988.02150100088034.
Neonates with necrotizing tracheobronchitis present a diverse clinical spectrum from asymptomatic disease to severe airway obstruction. A retrospective clinicopathologic study of 206 neonatal autopsy reports spanning a three-year period yielded 122 cases of necrotizing tracheobronchitis with an incidence of 59%. All study patients received treatment prior to the development of high-frequency ventilator jet, oscillator, or interruption. The site and submucosal depth of airway involvement was variable. The most commonly affected anatomic site was the middle or thoracic trachea (56%). The common cause identified was severe ischemia to the airway mucosa and submucosa, occurring with profound birth asphyxia and/or shock. The presence of ischemia supports the concept that decreased tracheoperfusion may be an important factor in the development of tracheobronchial abnormalities.
患有坏死性气管支气管炎的新生儿临床表现多样，从无症状疾病到严重气道阻塞不等。一项为期三年的对206份新生儿尸检报告的回顾性临床病理研究发现122例坏死性气管支气管炎病例，发病率为59%。所有研究患者在高频呼吸机喷射、振荡或中断之前均接受了治疗。气道受累的部位和黏膜下层深度各不相同。最常受累的解剖部位是气管中部或胸段气管（56%）。确定的常见病因是气道黏膜和黏膜下层严重缺血，发生于严重的出生窒息和/或休克时。缺血的存在支持了气管灌注减少可能是气管支气管异常发展的一个重要因素这一观点。
