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1、早产儿III〜IV级肺透明膜病使用固尔苏后胸部X线动态观察汪建华，肖飞鹰，孙多成，刘超凡(中山市博爱医院放射科，广东中山528400)摘要：目的分析早产儿III〜IV级肺透明膜病(HMD)应用肺表面活性物质(PS)固尔苏后胸部X线影像动态变化特点，探讨应用PS后胸片随访对评估疗效、发现胸部并发症的临床价值。方法冋顾经临床和影像学确诊为III〜IV级HMD,并应用PS治疗的早产儿病例，分析用药后l/2h、6h、24h、48h、5d胸片表现。结果用药后l/2h胸片双肺透亮度即有改善15例；肺部表现进行性改善，较前次胸片好转16例；
2、病变无改变或进展5例，其中并发肺出血1例，出现气漏3例；伴有肺部炎症样改变3例；动脉导管开放(PDA)11例。X线表现与临床症状平行。结论使用PS治疗后胸片动态观察能对III〜IV级HMD病变转归作出止确判断，短期复查能及时发现HMD并发症。关键词早产儿；肺透明膜病；固尔苏；并发症；彫像学ADynamicObservationoftheX-rayImagesinChestafterApplyingCurosurftoHyalineMembraneDiseaseinGradeIII〜IVofthePrematureInfants
3、，LungsWANGJian-hua,XIAOFei-ying,SUNDuo-cheng,LIUChao-fan(DepartmentofRadiology,BoaiHospitalinZhongshanCity,Zhongshan528400,Guangdong,China)[Abstract]Objective:ToanalyzethecharacteristicsofthedynamicchangesoftheradiologicalX-rayimagesinchestafterapplyingapulmonarysur
4、factant(PS)namedCurosurftohyalinemembranediseaseinGradeIII〜IVoftheprematurelungs,andtostudytheclinicalvaluesofthefollow-upswithchestfilmsafterapplyingPStoevaluateitseffectsandtodetectthecomplicationsinchest・Methods:ToreviewthedefinitecasesofHMDinGradeIII〜IVwithfinal
5、clinicalandradiologicaldiagnosissoastoanalyzetheradiologicalimagemanifestationsinchestafterapplyingPStotheprematurelungsforhalfanhour,for6hours,for24hours,for48hoursandfor5days.Results:ShortlyaftertheapplicationofPS,accordingtothechestfilms,justhalfanhourlater,15cas
6、esimprovedtheirdegreesofthetransmittanceofthetwolungs;16casesprogressivelyamelioratedtheirnirniifestotionsinchest,takingtheturnforthebetterthanthepreviousimages;5caseshadnoimprovement,amongwhich1developedacomplicationofpulmonaryhemorrhage,and3developedpulmonaryairle
7、akage;3casesaccompaniedwithpulmonaryinflammation-likelesions;11casespresentedpatentarterialducts(PDA).Generallyspeaking,theX-rayimagemanifestationwasthesameastheclinicalsymptoms.Conclusion:AdynamicobservationoftheX-rayfilmsinchestaftertheapplicationofPSisabletomakea
8、correctjudgementofthelesionsofHMDinGradellT^IX',andcanpromptlydetectitscomplicationsiftakingashort-termreview・【Keywords]Prematureinfants；H
