新生儿呼吸衰竭病因分析与预防

AN ANALYSIS ON THE CAUSES AND PREVENTION MEASURESOF NEONATAL RESPIRATORY FAILURE

目的：分析新生儿呼吸衰竭的病因，以期减少其发病率。方法：对我院１９９３年３月～１９９８年３月收住的１２５例新生儿呼吸衰竭患儿进行了回顾性分析。结果：以呼吸系统疾病最多，共９８例（７８４％），肺炎８１例（６４８％），其中吸入性肺炎４４例（３５２％），感染性肺炎３７例（２９６％）。肺透明膜病１１例（８８％），湿肺３例（２４％），肺不张、膈膨出、纵隔疝各１例（２４％）。神经系统疾病２１例（１６８％），颅内出血１０例（８％），呼吸暂停１１例（８８％），其中原发性呼吸暂停４例，继发性呼吸暂停７例。先天性心脏病６例（４８％）。根据病因分析，新生儿呼衰与围产因素密切相关者７８例，占６２４％，其中宫内窘迫和出生时窒息的因素最多，其次是早产、异常分娩和产前、产程感染。结论：做好围产期保健是减少新生儿呼吸衰竭发病率的根本。为此提出预防的有关措施。

Objective To analyse the causes of neonatal respiratory failure so as to reduce the incidence. Methods: 125 neonates with respiratory failure, admitted to our hospital from March 1993 to March 1998, were retrospectively analysed. Results: 98 cases were found to have respiratory diseases (amounting to 78.4%), of which 81 with pneumonia (64.8% of the total), 44 aspiration pneumonia and 37 infectious pneumonia (35.2% and 29.6% of the total respectively). and 11 neonates with atelectasis, diaphragmatic eventration and diaphragmatic hernia (8.8%,2.4%,2.4% of the total respectively) Among 92 cases 21 were suffering nervous system diseases, of which 10 with intracranial hemorrhage (8% of the total) and 11 cases (8.8% of the total) with apnea (4 primary apnea and 7 secondary apnea). The rest 6 cases were of congenital heart diseases. Conclusion: neonatal respiratory failure seems to have a close association with the perinatal factors (amounting to 62.4%),with the asphyxia, perverse labour and premature birth as the dominant factors. Good perinatal health care is the key of reducing incidence of neonatal respiratory failure. The preventive measures are suggested in this article.