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新生儿气胸在早产儿和足月儿中的结局。

Neonatal Pneumothorax Outcome in Preterm and Term Newborns.

机构信息

Department of Neonatology, Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

Department of Gynecology and Obstretics, Clinic for Gynecology and Obstetrics, University Clinical Center of Serbia, 11000 Belgrade, Serbia.

出版信息

Medicina (Kaunas). 2022 Jul 20;58(7):965. doi: 10.3390/medicina58070965.

Abstract

Background and Objectives: Pneumothorax implies the presence of air in the pleural space between the visceral and parietal pleura. The aim of this study was to investigate the incidence, clinical characteristics, risk factors, therapy and perinatal outcome in neonates with pneumothorax in a tertiary care center. Materials and Methods: A retrospective study based on a five-year data sample of neonates with pneumothorax was conducted in a Maternity Hospital with a tertiary NICU from 2015 to 2020. We included all neonates with pneumothorax born in our hospital and compared demographic characteristics, perinatal risk factors, anthropometric parameters, comorbidities, clinical course and method of chest drainage between term (≥37 GW) and preterm (<37 GW) neonates. Results: The study included 74 newborns with pneumothorax, of which 67.6% were male and 32.5% were female. The majority of women (59.5%) had no complications during pregnancy. Delivery was mainly performed via CS (68.9%). Delivery occurred on average in 34.62 ± 4.03 GW. Significantly more (p = 0.001) children with pneumothorax were born prematurely (n = 53; 71.6%) than at term (n = 21; 28.4%). Most of the neonates had to be treated with ATD (63.5%) and nCPAP (39.2%), but less often they were treated with surfactant (40.5%) and corticosteroids (35.1%). O2 therapy lasted an average of 8.89 ± 4.57 days. Significantly more (p = 0.001) neonates with pneumothorax had additional complications, pneumonia, sepsis, convulsions and intraventricular hemorrhage (68.9%). However, most children had a good outcome (83.8%) and were discharged from the clinic. Fatal outcomes occurred in six cases, while another six neonates had to be transferred to referral neonatal centers for further treatment and care. Conclusion: Significantly more children with pneumothorax were born prematurely than at term. With adequate therapy, even premature newborns can successfully recover from pneumothorax.

摘要

背景与目的

气胸是指脏层胸膜和壁层胸膜之间的胸腔内存在空气。本研究旨在探讨三级保健中心新生儿气胸的发生率、临床特征、危险因素、治疗方法和围生期结局。

材料与方法

这是一项回顾性研究,基于 2015 年至 2020 年在一家妇产医院和一家三级新生儿重症监护病房(NICU)五年的气胸新生儿数据样本。我们纳入了我院所有出生的气胸新生儿,并比较了足月(≥37 周)和早产(<37 周)新生儿的人口统计学特征、围生期危险因素、人体测量参数、合并症、临床病程和胸腔引流方法。

结果

本研究共纳入 74 例气胸新生儿,其中男婴占 67.6%,女婴占 32.5%。大多数女性(59.5%)在孕期无并发症。分娩方式主要为剖宫产(68.9%)。平均分娩孕周为 34.62±4.03 周。气胸患儿中,早产儿(n=53;71.6%)明显多于足月儿(n=21;28.4%)(p=0.001)。大多数新生儿需要接受 ATD(63.5%)和 nCPAP(39.2%)治疗,但接受表面活性物质(40.5%)和皮质类固醇(35.1%)治疗的比例较低。氧疗平均持续 8.89±4.57 天。气胸患儿合并肺炎、败血症、抽搐和脑室出血的比例明显更高(p=0.001;68.9%)。然而,大多数患儿预后良好(83.8%),并从诊所出院。6 例患儿死亡,6 例患儿需转至上级新生儿中心进一步治疗和护理。

结论

早产儿气胸患儿明显多于足月儿。通过适当的治疗,即使是早产儿也能成功从气胸中恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f39f/9320446/b3981acfc4f0/medicina-58-00965-g001.jpg

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