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目的该研究旨在调查伊朗伊斯法罕新生儿重症监护中心(NICU)住院新生儿气胸的发病因素、发生率和死亡率。方法 738例入住NICU的新生儿中,43例发生了气胸。回顾性分析气胸患儿的临床资料,包括胎龄、出生体重、Apgar评分、出生方式、母亲年龄、产次、围产期窒息、出生时复苏、气胸发生部位、机械通气情况、肺表面活性物质治疗、肺部疾病等。结果气胸患儿平均胎龄为31周,出生体重为1596g。12例(28%)患儿胎龄小于28周。28例(65%)出生体重低于1500g。共43例(5.8%)新生儿发生了气胸。97%的气胸为单侧(n=63),双侧气胸仅占3%(n=2)。呼吸窘迫综合征(40/43,93%)和机械通气(37/43,86%)是导致气胸发生的常见原因。共28例(65%)患儿死亡。死亡患儿与幸存患儿出生体重、胎龄及胸管留置时间差异有统计学意义。需要肺表面活性物质治疗的气胸患儿死亡率显著增加,与无需表面活性物质治疗的气胸患儿比较差异有统计学意义。结论该研究中气胸的发生率与死亡率高于其他报道,其原因可能是该研究中新生儿出生体重和胎龄都较低。呼吸窘迫综合征和机械通气是导致新生儿气胸发生的常见原因。患儿胎龄越小,体重越低,肺部疾病越严重,死亡率则越高。
Purpose The study was designed to investigate the incidence, incidence and mortality of neonates with pneumothorax in hospitalized neonatal intensive care unit (NICU) in Isfahan, Iran. Methods Of the 738 newborns admitted to the NICU, 43 developed pneumothorax. The clinical data of children with pneumothorax were retrospectively analyzed, including gestational age, birth weight, Apgar score, birth pattern, maternal age, parity, perinatal asphyxia, recovery at birth, location of pneumothorax, mechanical ventilation, pulmonary surfactant Treatment, lung disease and so on. Results The average gestational age of children with pneumothorax was 31 weeks and the birth weight was 1596g. Twelve (28%) children with gestational age were less than 28 weeks. 28 cases (65%) birth weight less than 1500g. A total of 43 infants (5.8%) developed pneumothorax. 97% of the pneumothorax was unilateral (n = 63), bilateral pneumothorax accounted for only 3% (n = 2). Respiratory distress syndrome (40 / 43,93%) and mechanical ventilation (37 / 43,86%) are common causes of pneumothorax. A total of 28 patients (65%) died of the disease. The difference of birth weight, gestational age and chest tube indwelling time between children with death and surviving children was statistically significant. The mortality of pneumothorax children who needed pulmonary surfactant treatment was significantly higher than that of pneumothorax without surfactant treatment. Conclusions The incidence and mortality of pneumothorax in this study were higher than those reported elsewhere, probably due to the low birth weight and gestational age of newborns in this study. Respiratory distress syndrome and mechanical ventilation are common causes of neonatal pneumothorax. Children with smaller gestational age, lower body weight, lung disease, the more serious, the higher the mortality rate.