目的：探讨新生儿肺透明膜病(neonatal hyaline membrane disease，NHMD)的发生机制、临床病理特点及提高对NHMD的认识，以保证正常医疗次序的进行。方法：回顾性分析遵义医学院附属医院病理科2009年1月至2015年12月12例NHMD的临床及尸检病理资料。结果：12例NHMD中女婴3例、男婴9例；生存期8 h~3 d，其中早产儿9例、剖宫产儿3例；12例NHMD出生时一般情况尚好，均于出生后6 h内出现进行性呼吸困难、青紫、呼气性呻吟、吸气性三凹征，并呼吸衰竭死亡。病理改变均出现肺泡管壁、终末毛细支气管壁上有一层透明的均匀无结构或颗粒状嗜伊红膜样物附着。结论：NHMD多发生于早产儿，发病机制除了肺泡表面活性物质的不足以外，还认为是自由基的产生和氧化应激的炎症过程，同时加强孕产保健及提高对该病的认识极为重要，以减少新生儿病死率及医疗纠纷。%Objective: To explore the pathogenesis, clinicopathological characteristics neonatal hyaline membrane disease (NHMD), improves the cognition of NHMD, and increase diagnosis level.Methods: Retrospective analysis underwent in 12 NHMD cases of clinical and pathological data in the Pathology Department of Affliated Hospital of Zunyi Medical College from January 2009 to December 2015.Results: hTere were 3 cases of female and 9 cases of male in 12 cases NHMD; survival period was ranging from 8 hours to 3 days; the 12 cases including 9 cases of premature infants, 3 cases of cesarean section. All 12 cases were in good condition when they were born. In 6 hours after birth, they presented with progressive dyspnea, cyanosis, breath groan, and eventually died of respiratory failure. hTe pathological changes indicated a alveolar, end bronchial capillary wall with a layer of transparent uniform structure or granular eosinophilic membrane attachment.Conclusion: NHMD was usually occured in premature infant, pathogenesis not only is the deifciency of pulmonary surfactant, but also it is believed to free radical generation and oxidative stress in the inlfammatory process, while it is extremely important to strengthen the maternal health care and raise awareness of the disease in order to reduce the neonatal mortality and medical disputes.
展开▼
