CAJ | 학술논문

目的：比较不同胎龄新生儿呼吸窘迫综合征（RDS）的高危因素、并发症、治疗及预后情况。方法选择2012年8月至2013年7月收治入院的156例RDS新生儿，依据胎龄分为早期早产儿组（出生胎龄<34周）42例，晚期早产儿组（出生胎龄34~36周）52例，足月儿组（出生胎龄≥37周）62例。回顾性分析RDS新生儿的基本情况、围生期高危因素、临床特点、治疗及预后。结果156例RDS新生儿中，男女比例2.25：1；3组新生儿均以男性比例为高，但组间差异无统计学意义（P=0.923）；发病时间和入院年龄随胎龄增加均有递增趋势，组间差异有统计学意义（P均<0.05）。3组新生儿高危因素分析，出生窒息、胎盘异常、多胎妊娠、胎膜早破，均以早期早产儿最多，晚期早产儿次之；足月儿剖宫产率最高；早期早产儿不明原因早产概率高于晚期早产儿，差异均有统计学意义（P均<0.05）。3组新生儿中，足月儿的肺表面活性物质（PS）应用率最低；早期早产儿X线分级Ⅱ级以上的比例最高，吸氧和住院时间最长，差异均有统计学意义（P<0.05）。早期早产儿合并肺部感染、颅内出血、支气管肺发育不良的概率均为最高，足月儿合并气胸的比例最高，差异均有统计学意义（P均<0.05）。3组新生儿中，早期早产儿治愈率最低，差异有统计学意义（P<0.01）。结论不同胎龄RDS新生儿的发病特点、高危因素、并发症及治疗反应均存在差异，因此在诊断和治疗的时候需考虑胎龄因素。对于足月儿要严格掌握择期剖宫产的指证，减少RDS发生。
목적：비교불동태령신생인호흡군박종합정（RDS）적고위인소、병발증、치료급예후정황。방법선택2012년8월지2013년7월수치입원적156례RDS신생인，의거태령분위조기조산인조（출생태령<34주）42례，만기조산인조（출생태령34~36주）52례，족월인조（출생태령≥37주）62례。회고성분석RDS신생인적기본정황、위생기고위인소、림상특점、치료급예후。결과156례RDS신생인중，남녀비례2.25：1；3조신생인균이남성비례위고，단조간차이무통계학의의（P=0.923）；발병시간화입원년령수태령증가균유체증추세，조간차이유통계학의의（P균<0.05）。3조신생인고위인소분석，출생질식、태반이상、다태임신、태막조파，균이조기조산인최다，만기조산인차지；족월인부궁산솔최고；조기조산인불명원인조산개솔고우만기조산인，차이균유통계학의의（P균<0.05）。3조신생인중，족월인적폐표면활성물질（PS）응용솔최저；조기조산인X선분급Ⅱ급이상적비례최고，흡양화주원시간최장，차이균유통계학의의（P<0.05）。조기조산인합병폐부감염、로내출혈、지기관폐발육불량적개솔균위최고，족월인합병기흉적비례최고，차이균유통계학의의（P균<0.05）。3조신생인중，조기조산인치유솔최저，차이유통계학의의（P<0.01）。결론불동태령RDS신생인적발병특점、고위인소、병발증급치료반응균존재차이，인차재진단화치료적시후수고필태령인소。대우족월인요엄격장악택기부궁산적지증，감소RDS발생。
Objective To compare the high risk factors, complications, treatment and prognosis of respiratory distress syndrome (NRDS) in neonates at different gestational age (GA). Methods Between August 2012 and July 2013, 156 neonates with RDS were selected and distributed into 3 groups, 42 early preterm (GA<34weeks), 52 late preterm (GA 35 to 36 weeks), and 62 in term group (GA≥37 weeks). Retrospectively analysis was performed for high risk factors, complications, treatment and prognosis of the three groups. Results In 156 neonates with RDS, the male and female proportion was 2.25:1. All groups had more males, but the gender difference has no statistical signiifcance in three groups (P=0.923). The onset time of RDS and the hospitalization time both show an increasing trend of statistical signiifcance (P<0.05). Comparing the difference of high risk factors for RDS of the 3 groups, birth asphyxia, placental abnormalities, multiple pregnancy, premature rupture of membranes was most common in early preterm group, and followed by late preterm group, and C-section was most common in term group and unexplained preterm was more common in early preterm group than that in late preterm group (all P<0.05). Among the three groups, the ratio of pulmonary surfactant application was the lowest in the term group, the ratio of X-ray grade over II was high-est in early preterm group, oxygen and hospitalization time were the longest in early preterm group (P<0.05). The risks of com-plicated with pulmonary infection, intracranial hemorrhages and bronchopulmonary dysplasia were the highest in early preterm group and the risk of complicated pneumothorax was the highest in term group. Among three groups, the recovery rate was the lowest in the early preterm group (P<0.01). Conclusion The clinical characteristics, high risk factors, complications and treat-ment responses of RDS in neonates with different GA were different, so GA should be considered for diagnose and treatment. For the term infants, the elective caesarean section should be strictly controlled, in order to reduce the incidence of RDS.