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报告2例均为足月剖腹产儿,胎儿取出后有缺氧症状而行气管插管并加压给氧,症状未改善,发现为一侧气胸,其中1例经抢救无效死亡。分析原因可能是气管导管太深或正压通气压力太高。为避免医源性的新生儿气胸,要注意:①吸净上呼吸道粘液或胎粪。②插管不要太深(插至声门下2cm为宜)。③正压通气压力在开始张肺时为30～40cmH_0O,张肺后应减为10～20cmH_2O,潮气量为20～40ml,④心脏按压与吹气应按比例进行,不可同时施行。一旦诊为气胸,应立即行胸腔抽气,张力性气胸则可行闭式胸腔引流,引流前禁忌加压通气,以免加剧气胸。
2 cases were reported for full-term caesarean section, fetal hypoxia symptoms after removal of the tracheal intubation and pressurized oxygen, the symptoms did not improve, was found on one side of the pneumothorax, of which 1 died after rescue ineffective. Analysis may be due to endotracheal tube too deep or positive pressure ventilation pressure is too high. To avoid iatrogenic neonatal pneumothorax, pay attention to: ① suck the upper respiratory tract mucus or meconium. ② not too deep intubation (plug to the glottis 2cm appropriate). ③ positive pressure ventilation at the beginning of the lungs for the 30 ~ 40cmH_0O, Zhang lung should be reduced to 10 ~ 20cmH_2O, tidal volume of 20 ~ 40ml, ④ heart pressure and inflatable should be carried out in proportion to not be implemented at the same time. Once the diagnosis of pneumothorax, should immediately line the chest pumping, tension pneumothorax is feasible closed chest drainage, drainage taboo before ventilation, so as not to aggravate pneumothorax.