Banerjee C K, Girling D J, Wigglesworth J S
Arch Dis Child. 1972 Aug;47(254):509-18. doi: 10.1136/adc.47.254.509.
A retrospective clinicopathological study was carried out on newborn babies who had died over a 5-year period, had received oxygen therapy, and had lived for 48 hours or longer. 23 of 81 babies had pulmonary fibroplasia at necropsy. Prolonged therapy in oxygen concentrations above 60% and prolonged artificial ventilation were associated with the development of pulmonary fibroplasia. All babies developing pulmonary fibroplasia had been treated in over 60% oxygen for at least 46 hours and the condition was invariably present in those who had over 60% oxygen for more than 123 hours or above 80% oxygen for more than 105 hours. The relation of pulmonary fibroplasia to mechanical ventilation was less constant. Hyaline membrane disease was associated with the development of fibroplasia in babies who lived for 3 days or longer, and the most severe histological changes were almost always associated with HMD. There was no correlation between gestational age and development of pulmonary fibroplasia. It is concluded that oxygen toxicity was probably the most important cause of pulmonary fibroplasia in the babies studied, though some histological features may be more closely related to artificial ventilation. The implications of these findings for oxygen and ventilator therapy in the newborn are discussed.
对5年内死亡、接受过氧疗且存活48小时或更长时间的新生儿进行了一项回顾性临床病理研究。81例婴儿中有23例在尸检时出现肺纤维增生。氧浓度高于60%的长时间治疗和长时间人工通气与肺纤维增生的发生有关。所有发生肺纤维增生的婴儿均接受了至少46小时的60%以上的氧疗，在接受60%以上的氧疗超过123小时或80%以上的氧疗超过105小时的婴儿中，这种情况总是存在。肺纤维增生与机械通气的关系不太稳定。透明膜病与存活3天或更长时间的婴儿的纤维增生发展有关，最严重的组织学变化几乎总是与透明膜病相关。胎龄与肺纤维增生的发展之间没有相关性。得出的结论是，尽管一些组织学特征可能与人工通气关系更密切，但氧中毒可能是所研究婴儿肺纤维增生的最重要原因。讨论了这些发现对新生儿氧疗和通气治疗的意义。
