临床儿科杂志 ›› 2019, Vol. 37 ›› Issue (2): 89-.doi: 10.3969/j.issn.1000-3606.2019.02.003

• 呼吸系统疾病专栏 • 上一篇    下一篇

肺部超声诊断新生儿气胸1例报告

强光峰, 赵静, 任雪云   

  1. 济宁医学院附属医院新生儿重症监护室(山东济宁 272000)
  • 出版日期:2019-02-15 发布日期:2019-02-26
  • 通讯作者: 任雪云 电子信箱:441024311@qq.com

Lung ultrasound for diagnosing neonatal pneumothorax : a case report and literature review

QIANG Guangfeng, ZHAO Jing, REN Xueyun   

  1. Department of Neonatal Intensive Care Unit, Affiliated Hospital of Jining Medical University, Jining 272000, Shandong, China
  • Online:2019-02-15 Published:2019-02-26

摘要: 目的 探讨肺部超声诊断新生儿气胸的临床价值。方法 分析1例突然出现呼吸困难、血氧饱和度下降时, 使用肺部超声诊断为气胸的新生儿的临床资料,并复习相关文献。 结果 男性新生儿,出生40分钟后出现呻吟、气促等呼 吸窘迫症状,予经鼻持续气道正压通气(NCPAP)辅助通气。入院20分钟(生后1小时30分钟)后行肺部超声检查提示存 在气胸。停用NCPAP改为气管插管、高频震荡呼吸机辅助呼吸。入院约2小时(生后3小时10分钟)患儿呼吸困难加重, 血氧饱和度下降至60%,听诊右肺呼吸音略低,急查肺部超声示气胸加重。予紧急胸腔穿刺,抽出气体约100 mL后患儿 呼吸困难缓解,经皮血氧饱和度上升至95%以上,住院10天痊愈出院。结论 肺部超声诊断新生儿气胸具有准确、方便、 快捷、无电离辐射,可作为诊断新生儿气胸的重要影像学检查手段。

关键词: 肺部超声; 气胸; 新生儿

Abstract:  Objective To study the clinical value of lung ultrasound (LUS) in the diagnosis of neonatal pneumothorax. Methods The clinical data of a case of neonatal pneumothorax diagnosed by LUS in a newborn with sudden dyspnea and decreased oxygen saturation were retrospectively analyzed. Relevant literatures were reviewed. Results A newborn was admitted to NICU with “groaning and anhelation for 30 minutes” and given nasal continuous positive airway pressure. LUS was performed 20 minutes after admission, suggesting pneumothorax. We discontinued nasal continuous positive airway pressure to a high-frequency oscillating ventilator. About 2 hours after admission, the infant's breathing difficulties increased, and the oxygen saturation decreased to 60%. Due to the delay of chest X ray, we examined the infant by LUS immediately, and found that pneumothorax was aggravated. Then LUS-guided emergency thoracic puncture was performed. The infant's condition improved significantly. Conclusions Using LUS to diagnose neonatal pneumothorax is highly accurate, convenient, fast, and free of ionizing radiation. LUS should be an important imaging alternative for the diagnosis of neonatal pneumothorax.

Key words:  lung ultrasound; pneumothorax; newborn