不同胎龄新生儿呼吸窘迫综合征临床特征分析

摘要

目的 探讨分析不同胎龄新生儿呼吸窘迫综合征(NRDS)的临床特征及主要危险因素.方法 收集NRDS早产儿122例,按胎龄将早产儿分为两组:＜34周为早期早产儿组(93例),34～ ＜37周为晚期早产儿组(29例).比较两组NRDS早产儿一般情况、围生期高危因素、治疗情况及合并症发生情况.结果 两组早产儿机械通气、同步间歇指令通气(SIMV)、经鼻持续气道正压通气(nCPAP)例数及机械通气时间、SIMV时间、nCPAP时间比较差异均无统计学意义(均P＞0.05).早期早产儿组一般氧疗、总氧疗及住院时间要长于晚期早产儿组,差异均有统计学意义[均P＜0.05).晚期早产儿组NRDS病情更重,重复使用肺表面活性物质率要高于早期早产儿组,差异有统计学意义(P＜0.05).早期早产儿组肺部感染、支气管肺发育不良、败血症、输血发生率均高于晚期早产儿组,差异均有统计学意义(均P＜0.05).两组早产儿颅内出血、动脉导管未闭、心功能不全、气胸发生率比较差异均无统计学意义(均P＞0.05).结论 NRDS的发生以早期早产儿为主,不同胎龄NRDS患儿的发病特点、合并症及治疗反应均存在差异,因此在诊断和治疗时应考虑胎龄因素,从而为指导临床诊疗,采取更合理的防治方案提供依据.%Objective To investigate clinical characteristics and risk factor of neonatal respiratory distress syndrome (NRDS) in newborns of different gestational age.Methods Clinical data of 122 newborns with neonatal respiratory distress syndrome were retrospectively analyzed,including 93 cases with gestational age＜34 weeks (early preterm group) and 29 cases with gestational age ＜37 weeks (late preterm group).The basic conditions,perinatal high risk factors,treatment and complications of the two groups were compared.Results There were no significant differences in durations of mechanical ventilation,synchronized intermittent mandatory ventilation (SIMV) and nasal continuous positive airway pressure (nCPAP) between two groups(all P ＞0.05).But the time of oxygen therapy and the length of hospital stay in early preterm group was longer than those in late preterm group (all P＜0.05).The condition of NRDS was more serious and the requirement of reuse pulmonary surfactant was more common in late preterm group than those in early preterm group (P＜0.05).The risks of pulmonary infection,bronchopulmonary dysplasia,septicemia and blood transfusion in early preterm infants were higher than those in late preterm group(all P＜0.05).But there were no significant differences in the incidence of intracranial hemorrhage,patent ductus arteriosus,cardiac insufficiency and pneumothorax between the two groups (all P ＞0.05).Conclusion NRDS predominantly occurs in early preterm infants.The clinical characteristics,complications and treatment responses of NRDS with different gestational age are different.So gestational age should be considered for diagnose and treatment.