Hook B, Hack M, Morrison S, Borawski-Clark E, Newman N S, Fanaroff A
Case Western Reserve University, Rainbow Babies and Childrens Hospital, Cleveland, OH 44106, USA.
J Perinatol. 1995 Jan-Feb;15(1):27-31.
The objective of this study was to describe the incidence, neonatal correlates, and outcome of pneumopericardium (PPC) in very low birth weight (VLBW) < or = 1.5 kg infants. Forty-seven VLBW infants with a PPC, born during 1977 to 1989, were compared with a cohort of 1302 ventilated VLBW infants. PPC developed in 2% of 2389 VLBW infants and 3.5% of 1349 ventilated infants. The mean birth weight (1008 +/- 220 gm), and mean gestation (27 +/- 2 weeks) of the PPC cohort was similar to the control cohort. Thirty-two (68%) of the infants with PPC were male, compared with 691 (53%) of the ventilated infants (p < 0.05). Eight (17%) of the infants with PPC survived, compared with 780 (60%) of the control cohort (p < 0.00001). The oxygenation index significantly increased before PPC, and was significantly higher in nonsurvivors than survivors. Four (50%) of the PPC survivors had neurodevelopmental impairment at 20 months, compared with 35% of the control cohort. Pneumopericardium is a rare event with high morbidity and mortality. Clinicians should suspect this diagnosis in VLBW infants with a rising oxygenation index and subsequent acute deterioration.
本研究的目的是描述出生体重极低（VLBW）≤1.5kg婴儿发生心包积气（PPC）的发生率、新生儿相关因素及转归。将1977年至1989年期间出生的47例患有PPC的VLBW婴儿与一组1302例接受机械通气的VLBW婴儿进行比较。2389例VLBW婴儿中有2%发生PPC，1349例接受机械通气的婴儿中有3.5%发生PPC。PPC组婴儿的平均出生体重（1008±220g）和平均孕周（27±2周）与对照组相似。PPC组中有32例（68%）婴儿为男性，而接受机械通气的婴儿中有691例（53%）为男性（p<0.05）。PPC组中有8例（17%）婴儿存活，而对照组中有780例（60%）存活（p<0.00001）。在发生PPC之前，氧合指数显著升高，且非存活者的氧合指数显著高于存活者。PPC组存活的婴儿中有4例（50%）在20个月时存在神经发育障碍，而对照组中这一比例为35%。心包积气是一种罕见事件，发病率和死亡率高。临床医生应怀疑在氧合指数升高并随后出现急性病情恶化的VLBW婴儿中存在此诊断。
