中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
Chinese Journal of Woman and Child Health Research
2015年
4期
721-723
,共3页
晚期早产儿%足月儿%胎龄<35周早产儿%呼吸窘迫综合征%临床分析
晚期早產兒%足月兒%胎齡<35週早產兒%呼吸窘迫綜閤徵%臨床分析
만기조산인%족월인%태령<35주조산인%호흡군박종합정%림상분석
late-preterm neonates%gestational age<35w premature neonates%respiratory distress syndrome (RDS)%clinical analysis
目的 比较晚期早产儿及足月儿与胎龄<35周早产儿呼吸窘迫综合征( RDS)的特点,探讨晚期早产儿及足月儿与胎龄<35周早产儿RDS的临床特征的差异. 方法 2011年12月至2013年12月在兰溪市人民医院住院的89例RDS患儿,按照胎龄分为胎龄≥35周的晚期早产儿及足月儿组(32例)和胎龄<35周早产儿组(57例). 就其发病危险因素、发病时间、治疗及并发症进行对比分析. 结果 胎龄<35周早产儿RDS的危险因素主要为早产,晚期早产儿及足月儿RDS的危险因素主要为剖宫产(59.4%),其次为窒息、胎粪吸入、母妊娠合并糖尿病等(χ2 值分别为6.52、6.47、9.24、4.15,均P<0.05). 晚期早产儿及足月儿组出现临床症状较胎龄<35周早产儿组晚(t=3.92,P<0.01),开始应用持续正压通气(CPAP)或呼吸机的时间亦较晚(t=4.20,P<0.01),而持续应用呼吸机的时间较胎龄<35周早产儿组长(t=2.27,P<0.05);与胎龄<35周早产儿组相比更易并发气胸(χ2 =5.82,P<0.05)及持续肺动脉高压(PPHN)(χ2 =9.49,P<0.01). 结论 剖宫产、胎粪吸入、窒息、母妊娠合并糖尿病等是晚期早产儿及足月儿发生RDS的危险因素;晚期早产儿及足月儿出现呼吸窘迫的时间比胎龄<35周早产儿要晚,机械通气时间较长,容易发生气胸和持续肺动脉高压. 故积极地防治新生儿窒息、胎粪吸入,减少剖宫产可减少晚期早产儿及足月儿RDS的发生. 同时要提高临床医生对晚期早产儿及足月儿RDS的认识,做到早诊断、早治疗,改善其预后.
目的 比較晚期早產兒及足月兒與胎齡<35週早產兒呼吸窘迫綜閤徵( RDS)的特點,探討晚期早產兒及足月兒與胎齡<35週早產兒RDS的臨床特徵的差異. 方法 2011年12月至2013年12月在蘭溪市人民醫院住院的89例RDS患兒,按照胎齡分為胎齡≥35週的晚期早產兒及足月兒組(32例)和胎齡<35週早產兒組(57例). 就其髮病危險因素、髮病時間、治療及併髮癥進行對比分析. 結果 胎齡<35週早產兒RDS的危險因素主要為早產,晚期早產兒及足月兒RDS的危險因素主要為剖宮產(59.4%),其次為窒息、胎糞吸入、母妊娠閤併糖尿病等(χ2 值分彆為6.52、6.47、9.24、4.15,均P<0.05). 晚期早產兒及足月兒組齣現臨床癥狀較胎齡<35週早產兒組晚(t=3.92,P<0.01),開始應用持續正壓通氣(CPAP)或呼吸機的時間亦較晚(t=4.20,P<0.01),而持續應用呼吸機的時間較胎齡<35週早產兒組長(t=2.27,P<0.05);與胎齡<35週早產兒組相比更易併髮氣胸(χ2 =5.82,P<0.05)及持續肺動脈高壓(PPHN)(χ2 =9.49,P<0.01). 結論 剖宮產、胎糞吸入、窒息、母妊娠閤併糖尿病等是晚期早產兒及足月兒髮生RDS的危險因素;晚期早產兒及足月兒齣現呼吸窘迫的時間比胎齡<35週早產兒要晚,機械通氣時間較長,容易髮生氣胸和持續肺動脈高壓. 故積極地防治新生兒窒息、胎糞吸入,減少剖宮產可減少晚期早產兒及足月兒RDS的髮生. 同時要提高臨床醫生對晚期早產兒及足月兒RDS的認識,做到早診斷、早治療,改善其預後.
목적 비교만기조산인급족월인여태령<35주조산인호흡군박종합정( RDS)적특점,탐토만기조산인급족월인여태령<35주조산인RDS적림상특정적차이. 방법 2011년12월지2013년12월재란계시인민의원주원적89례RDS환인,안조태령분위태령≥35주적만기조산인급족월인조(32례)화태령<35주조산인조(57례). 취기발병위험인소、발병시간、치료급병발증진행대비분석. 결과 태령<35주조산인RDS적위험인소주요위조산,만기조산인급족월인RDS적위험인소주요위부궁산(59.4%),기차위질식、태분흡입、모임신합병당뇨병등(χ2 치분별위6.52、6.47、9.24、4.15,균P<0.05). 만기조산인급족월인조출현림상증상교태령<35주조산인조만(t=3.92,P<0.01),개시응용지속정압통기(CPAP)혹호흡궤적시간역교만(t=4.20,P<0.01),이지속응용호흡궤적시간교태령<35주조산인조장(t=2.27,P<0.05);여태령<35주조산인조상비경역병발기흉(χ2 =5.82,P<0.05)급지속폐동맥고압(PPHN)(χ2 =9.49,P<0.01). 결론 부궁산、태분흡입、질식、모임신합병당뇨병등시만기조산인급족월인발생RDS적위험인소;만기조산인급족월인출현호흡군박적시간비태령<35주조산인요만,궤계통기시간교장,용역발생기흉화지속폐동맥고압. 고적겁지방치신생인질식、태분흡입,감소부궁산가감소만기조산인급족월인RDS적발생. 동시요제고림상의생대만기조산인급족월인RDS적인식,주도조진단、조치료,개선기예후.
Objective To compare the clinical characteristics of respiratory distress syndrome ( RDS ) between gestational age <35w premature neonates and term and late-preterm neonates and the differences among them.Methods Eighty-nine cases of RDS admitted in People's Hospital of Lanxi City during the period of December 2011 to December 2013 were divided into two groups:term and late-preterm neonate group (gestational age≥35w, n=32) and gestational age<35w premature neonate group (gestational age<35w, n=57).The risk factors, onset time, treatment and complications of them were analyzed.Results Premature was the main etiology of RDS in gestational age<35w premature neonates, while cesarean section was the major high risk factor in term and late-preterm neonates (59.4%), followed by asphyxia, meconium aspiration and gestational diabetes mellitus (χ2 value was 6.52, 6.47, 9.24 and 4.15, respectively, all P<0.05).The occurrence of RDS was later (t=3.92,P<0.01) and the start time to use CPAP or ventilator was also later (t=4.20, P<0.01) in term and late-preterm neonate group than in gestational age<35w premature neonate group.But the continuous application of ventilator was longer (t=2.27,P<0.05) in term and late-preterm neonates, and they were more likely to suffer pneumothorax (χ2 =5.82,P<0.05) and persistent pulmonary hypertension (PPHN) (χ2 =9.49,P <0.01).Conclusion Cesarean section, meconium aspiration, asphyxia and gestational diabetes mellitus are the risk factors of term and late-preterm neonates with RDS.The onset time for RDS is late and mechanical ventilation is long in term and late-preterm neonates, who are likely to suffer pneumothorax and PPHN. Therefore, active preventing neonates asphyxia and meconium aspiration, and reducing cesarean section rate can significantly reduce the occurrence of RDS among term and late-preterm neonates.Meanwhile, it is important to improve clinician' s awareness on RDS to achieve early diagnosis and early treatment as well as better prognosis.
