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本文通过对35例新生儿纵隔气肿的临床分析,提示新生儿纵隔气肿是胎粪吸入综合征的严重并发症之一。多数发生在成熟儿,以窒息复苏后6小时出现气急、紫绀、吸气性三凹征为主要表现。易并发气胸,X线检查胸腺抬举征,心前或胸骨后积气征对诊断尤为重要。治疗的关键在于早期有效的纵隔减压,其中以胸骨旁多部位穿刺减压效果良好,操作简单、安全、创伤小。对反覆多部位穿刺后在短时间内出现张力性纵隔气肿者,可行切开引流或行经胸纵隔胸膜切开减压,对争取抢救时间,降低病死率有一定临床意义。
In this paper, 35 cases of neonatal mediastinal emphysema clinical analysis, suggesting that neonatal mediastinal emphysema meconium aspiration syndrome is one of the serious complications. Most occurred in mature children, with asphyxia resuscitation 6 hours after emergent, cyanosis, inspiratory concave three signs as the main performance. Easy to complicated pneumothorax, X-ray examination of thymus lifts, chest or heart sign before the syndrome is particularly important for the diagnosis. The key is the treatment of early effective mediastinal decompression, in which pleural para-multiple puncture decompression effect is good, simple, safe, less trauma. Repeated multi-site puncture in a short time after the emergence of tension-type mediastinal emphysema, viable incision and drainage or through the mediastinum pleural incision decompression, strive for rescue time and reduce mortality has some clinical significance.