Risk Factors of Pneumothorax in Infants with Hyaline Membrane Disease Receiving Intermittent Positive Positive Pressure Ventilation

肺透明膜病嬰兒接受間歇性增壓呼吸器時發生氣胸的危險因素

楊宏義(Horng-Yih Yang) ； 林其和(Chyi-Her Lin) ； 陣森輝(Shen-Hui Chen)

《Acta Paediatrica Sinica》 27卷4期 (1986/08) Pp. 307-314

摘要

從1983年7月至1985年6月，臺大醫院新生兒加謹病房共住進93例早產兒，選取其中31例接受呼吸器治療的肺透明膜病嬰兒者為木研究對象；16例屬氣胸組，15例屬對照組。比較這兩組，發現在性別、懷孕週數、出生體重、生產方式、1分鐘及5分鐘Apgar分數、院內生產或院外轉送、何時開始呼吸器治療、血清鈉離子濃度、胸部X光分級及肺體積方面並無差異。兩組之各種呼吸器指數的最大值及氣胸前24小時內各個指數值，也無明顯的差異。氣胸組的最高動脈二氧化碳分壓值偏低，可能表示具有較高的每分鐘換氣值，因而增加發生氣胸的機會。氣胸組在出生後第2天及氣胸發生前1天，水份的攝入明顯偏高。本文結論；接受呼吸器治療的肺透明膜病變的病例，在出生後的幾天內應給予水份的限制。

並列摘要

The charts of 93 premature infants admitted to the neonatal intensive care unit from July 1983 to June 1985 were reviewed. Thirty-one cases with hyaline membrane disease receiving mechanical ventilation were identified; 16 were in the pneumothorax group and 15, in the control group. No significant difference was found in the sex, gestational age, birth weight, type of delivery, one minute and five minutes Apgar scores, inborn or outborn, time of intermittent positive pressure ventilation started, serum sodium level, grading of chest X-ray findings or lung volume between the two groups. There was also no significant, difference in the maximum ventilator settings or each parameter during the 24 hours Prior to the occurrence of pneumothorax. The finding of a lower highest PaCO2 in the study group pointed to the possibility of their more minute ventilation with a consequently greater chance of developing pneumothorax. The fluid intake during the second day of life and the day prior to pneumothorax were higher in the study group. It was concluded that fluid intake in the first few days of life should be restricted for infants receiving intermittent positive uentilation for hyaline membrane disease.

並列關鍵字

pnseumothorax ； hyaline membrane disease ； intermittent positive pressure ventilation