极低出生体重儿呼吸病管理体会

Experiences in managing respiratory diseases of very low birth weight infants

目的本文总结10年呼吸管理体会,以期提高极低出生体重儿(VLBW I)成活率。方法1994—2004年两家三级甲等医院280例VLBW I,1999—2004年为A组156例,1994—1998年为B组124例。分析前后5年VLBW I管理措施改进等。结果①280例发生呼吸病168例(60.0%),A组66例(42.3%),B组102例(82.3%),两组有显著性差异(P<0.05);②A组均入NICU,采取监护及早期干预措施,呼吸病发生率显著下降,与B组对比有显著性差异(P<0.05);③呼吸病以呼吸暂停最多见,占78.6%,依次为呼吸困难38.7%,节律不整34.5%,周期性呼吸27.4%,呼吸浅表18.5%,叹息样呼吸16.7%,抽泣样呼吸7.1%;④两组死亡率对比由B组25.0%下降到A组10.3%(P<0.05)。结论入NICU早期药物干预可明显减少和减轻呼吸道合并症,降低死亡率。

Objective This article summarizes salvaging esperiences of late 10 years to guide the respiratory diseases for increase survival rate. Methods We totally got 280 VLBWI from two hospitals from 1994 to 2004. The group A includes 156 cases from 1998 to 2003. The group B includes 124 cases from 1993 to 1997. Then we analyze respiratory managing measure inprovement. Results ①168 cases of 280 cases （ 60. 0% ） happened respiratory diseases,66 cases of group A （ 42. 3 % ）, 102 cases of group B （ 82. 3 % ）. There is significant difference between the two groups （ P 〈 0. 05 ）.②The infants in group A were all put into NICU, and take intensive care and early intervention, respiratory diseases descend significantly. There is significant difference between the two groups（P 〈 0. 05）. ③The respiratory diseases mainly manifest apnea 78.6%, respiratory distress 38.7% ,irregular respiratory rhythm 34. 5%, periodical respiratory 27.4% ,superficial respiratory 18. 5% ,signing-like respiratory 7.1%.④The mortality is reduced from 25.0% of B to 10. 3% of A （ P 〈 0. 05 ）.⑤The accidental rate of respiratory diseases have close relation with gestational age and born weight. The gestational age is smaller and born weight is less the rate is higher. Conclusion Tranport to NICU in time and early drug intervention can take treatment and prevention respiratory complications obviously,reduce mortality of VLBWI.