Spontaneous Pneumothorax in the Newborn. |
Dong Gwan Han |
Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea |
新生兒 肺外空氣湯出 (自然氣胸의 臨床的 考察) |
韓東觀 |
延世醫大 小兒科學敎室 |
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Abstract |
A retrospective 13 medical records of symptomatic and spontaneous pneumothorax of newborn has been reviewed, which occurred during last 13 years from Jan. 1971 through Dec. 1983 at Pediatric Department of Yonsei Medical School. Spontaneous pneumothorax was defined one with pneumothorax which was not given positive pressure or intubation. And following results W6re obtained; 1)The incidence of spontaneous pneumothorax in live-birth was 0.03% during the period. 2)Spontaneous pneumothorax occurred more frequently in female 61.5%, the incidence higher in full-term and post-term(84.6%). 3)Prenatal complications were associated in 53.8%, cesarean section was observed in 30.8% and 23.1% had neonatal asphyxia. Underlying diseases associated respiratory distress were found in 69.2% (ex. meconium aspiration syndrome, transient tachypnea of newborn, hyaline membrane disease and congenital anomaly). 4)The symptoms and signs observed were cyanosis 84.6%, tachypnea 76.9%, chest retraction and decreased breath sound 61.5% in order of frequency, and 84.6% of them occurred within 24 hours after birth. On radiologic evaluation pneumothorax was right in 53.8% bilateral pneumothorax and an associated pneumomediastinum in 15.4% respectively. Mediastinal shift was present in 53.8%. 5)In 30.8% tolerated with only 100% O2 supply with hood and 69.2% required chest tube insertion with under-water trap and water-seal suction. Three of 13 newborns died(23.1%),
one with esophageal atresia, one with panperitonitis due to congenital stomach perforation,and one from severe neonatal asphyxia. |
Key Words:
Pneumothorax and Pneumomediastinum, Meconium aspiration syndrome |
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