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资源匮乏国家(几内亚科纳克里)新生儿气胸的临床表现及简易处理

Clinical presentation and improvised management of neonatal pneumothorax in the setting of a low-resource country: Conakry, Guinea.

作者信息

Merscher Alves Maria Bea, Conté N'fanly, Sory Diallo Ibrahima, Roth-Kleiner Matthias

机构信息

Pediatric and Neonatal Intensive Care Unit, Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland

Department of Neonatology, Institute of Nutrition and Child Health, Conakry, Guinea.

出版信息

BMJ Case Rep. 2021 Mar 22;14(3):e235801. doi: 10.1136/bcr-2020-235801.

Abstract

Two neonates were presented at the Neonatology Department of the Institute of Child Nutrition and Health in Conakry, Guinea, with tension pneumothoraces as confirmed by chest X-ray. They were initially managed with needle thoracentesis but required continuous thoracic drainage. Due to scarce resources in the public health sector, no prepacked and dedicated pleural drainage systems were available as is the case in many developing countries. Therefore, we fabricated an improvised underwater seal drain out of a plastic infusion bottle and a Heimlich valve out of a vicryl fingerstall. Both devices have shown to be effective. Pneumothorax is a common and potentially life-threatening disease in neonates that often requires prompt treatment. This case series demonstrates how tension pneumothorax in two newborns was successfully managed by improvising different chest drainage systems. The depicted techniques shall serve as an instruction manual to healthcare professionals working in low-resource settings and facing similar challenges.

摘要

几内亚科纳克里儿童营养与健康研究所新生儿科接收了两名新生儿,经胸部X光确诊为张力性气胸。他们最初接受了胸腔穿刺术治疗,但需要持续胸腔引流。由于公共卫生部门资源稀缺,像许多发展中国家一样,没有预包装的专用胸腔引流系统。因此,我们用一个塑料输液瓶制作了一个简易水封引流装置,并用一个维可牢手指套制作了一个海姆利希单向阀。这两种装置都已证明是有效的。气胸是新生儿常见且可能危及生命的疾病,通常需要及时治疗。本病例系列展示了如何通过临时制作不同的胸腔引流系统成功治疗两名新生儿的张力性气胸。所描述的技术应作为在资源匮乏环境中工作且面临类似挑战的医疗专业人员的操作指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dbf/7986683/4bf2287678f2/bcr-2020-235801f01.jpg

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