摘要
目的探讨新生儿心包积气的临床特征及治疗经过,并进行文献复习。方法选择2018年4月21日,于四川省妇幼保健院经剖宫产术分娩后约10 min时,出现气促、呻吟、面色青紫,立即在吸氧下转入四川省妇幼保健院新生儿科治疗的1例生后1 h+22 min心包积气新生儿为研究对象。采用回顾性分析方法,收集该例新生儿的临床病例资料,对其临床特征和诊治经过进行总结。本研究对新生儿心包积气文献进行复习时,设定的文献检索策略为:以"新生儿""心包积气""neonate"及"pneumopericardium"为中、英文关键词,在PubMed数据库、Wily Online Library、万方数据知识服务平台、维普中文科技期刊数据库中,检索新生儿心包积气相关文献,检索时间设定为2008年1月1日至2018年6月30日。总结心包积气新生儿的临床特点及诊治方法。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果对本例心包积气新生儿的研究结果如下。①病史采集:本例新生儿为男性,出生胎龄为36周,无胎膜早破、宫内窘迫及羊水粪染病史,出生体重为2 750 g,生后1、5、10 min Apgar评分分别为9、10、10分。②入院相关检查结果:胸部X射线摄片检查结果提示湿肺合并感染可能,新生儿呼吸窘迫综合征(NRDS)待排查;动脉血气分析结果提示呼吸性酸中毒;心脏彩色多普勒超声检查及血常规、C反应蛋白、电解质检查结果,以及肝、肾功能,均未见明显异常。③治疗与转归:本例新生儿经呼吸机辅助机械通气治疗后,出现大量心包积气,合并气胸、纵隔气肿、间质性气肿、皮下气肿等其他气漏综合征症状,并且合并心包填塞、心排血量低症状。临床对该例新生儿并未立即进行常规心包穿刺术,而是采取胸腔穿刺术+高频振荡通气(HFOV)治疗,新生儿接受此方法治疗后,心包积气于24 h内被完全吸收。新生儿住院治疗30 d后,治愈
Objective To explore the clinical features and treatment of neonatal pneumopericardium, and review the literatures. Methods On April 21, 2018, a neonate with pneumopericardium and 1 h+22 min after birth was selected as research subject. The neonate was delivered by cesarean section in Sichuan Provincial Hospital for Women and Children and developed shortness of breath, moan and purple complexion about 10 min after birth, and then was transferred into Department of Neonatology, Sichuan Provincial Hospital for Women and Children. The clinical data of the neonate was collected by retrospective analysis method, and the clinical features, diagnosis and treatment methods of the neonate were summarized. With the following keywords of "neonate" and "pneumopericardium" both in Chinese and English, literatures related to neonatal pneumopericardium were searched from PubMed database, Wily Online Library, Wanfang Data Knowledge Service Platform, and VIP database, and literatures retrieval time was set from January 1, 2008 to June 30, 2018, and clinical features, diagnosis and treatment methods of neonatal pneumopericardium in searched literature were summarized. This study was consistent with the World Medical Association Declaration of Helsinki revised in 2013. Results The results of the neonate with pneumopericardium in this study were as follows.①Family history: the neonate was a boy with 36 weeks of gestational age, and without premature rupture of membranes, intrauterine distress or history of meconium-stained amniotic fluid. His birth weight was 2 750 g, and the Apgar scores were 9, 10, 10 points at 1, 9, and 10 min after birth, respectively.②Results of admission examinations: chest X-ray radiography showed the possibility of wet-lung complicated with infection, and neonatal respiratory distress syndrome (NRDS) to be discharged. Arterial blood gas analysis suggested respiratory acidosis. There was no obvious abnormity in color doppler ultrasound examination of heart, and examinations of blood routine, C-reactive pr
作者
杜涛君
谢双宇
林元义
伍金林
Du Taojun;Xie Shuangyu;Lin Yuanyi;Wu Jinlin(Department of Pediatrics,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University),Ministry of Education,West China Second University Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China;Department of Neonatology,Sichuan Provincial Hospital for Women and Children,Chengdu 610031,Sichuan Province,China;Mianyang Military District Health Center of Sichuan,Mianyang 621000,Sichuan Province,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2019年第1期39-45,共7页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
国家自然科学基金资助项目(81401233)~~
关键词
心包积气
心排血量
低
心包穿刺术
胸腔穿刺术
通气机
机械
高频通气
治疗结果
婴儿
新生
Pneumopericardium
Cardiac output, low
Pericardiocentesis
Thoracentesis
Ventilators, mechanical
High-frequency ventilation
Treatment outcome
Infant, newborn
