Clinicao-Pathologic Study on Hyaline Membrane Disease. |
Jung Woo Suk1, Je G Chi2 |
1Department of Pediatrics, National Medical Center 2Department of Pathology,College of Medicine,Seoul National University |
流魂質膜症 (Hyaline Membrane Disease ) 의 臨皮的및病理學的觀察 |
石 正 字1, 池堤 根2 |
1國立醫療院 小兒科 2서울大學校 醫科大學 病理學敎室 |
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Abstract |
A total of 27 cases of hyaline membrane disease (idiopathic respiratory distress syndrome
was studied clinically, and postmortem findings were reviewed on 14 cases that were available:for autopsy.
These 27 cases were obtained during a period of 19 years from January, 1961 to December,1979, at National Medical Center, Seoul. Following results were obtained.
1. The overall incidence of hyaline membrane disease (HMD) among total births was 0.11%, and it was 1.2% among premature infants. Among C-section deliveries the incidence was 0.3%.
2. The hyaline membrane disease was most commonly seen among low birth weight infants, particularly those below the birth weight of 1,000 gm. And the incidence of HMD was highest in the group of infants under 30 weeks of gestation age, and was lowest in the group over 37 weeks gestation age.
3. The hyaline membrane disease was the cause of death in 5.7% of all neonatal deaths, and 7.8% in entire premature infants deaths. 4. The most common clinical manifestation was tachypnea, followed by grunting respiration cyanosis, chest retraction and apneic spells, in descending order of frequency.
5. The mortality of HMD in this series was 85.2%. Over 90% of patient succumbed within.48 hours after birth, and there was no death, after 72 postnatal hours. 6. Postmortem examination done on 14 cases showed characteristic hyaline membrane in;the lungs in all cases. Glassy eosionphilic membrane was lining the respiratory bronchioles,and alveolar ducts. Also prominent in the lungs were atelectasis, capillary congestion
lymphatic dilatation, interstitial edema and amniotic fluid aspiration. Among extrapulmonarjrlesion generalized visceral congestion, petechial hemorrhages on serosal surface and parenchymal,organs, and subarachnoid hemorrhage of the brain.
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Key Words:
Hyaline Membrane Disease, Surfactant, Clinicopathologic Study. |
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