足月儿急性呼吸窘迫综合征发病影响因素分析

Influence factors of acute respiratory distress syndrome in full-term neonates

目的探讨足月新生儿急性呼吸窘迫综合征(ARDS)的影响因素,提高对本病的认识,以降低其发生的风险。方法对2009年1月-2011年1月入住本院新生儿重症监护病房(NICU)的足月ARDS患儿27例进行回顾性研究,并与同期入院的非ARDS患儿402例进行成组资料的相关因素Logistic回归分析。结果 (1)足月新生儿ARDS的发生率为6.29%,发病时间多为生后3～6h(55.56%),且以缺氧和呼吸窘迫为主要特征,其胸部X线以Ⅲ级多见(48.15%)。(2)Logistic回归分析显示性别、胎龄、分娩方式、胎粪吸入、妊娠合并糖尿病对ARDS的发生有影响(P<0.05)。结论 ARDS发生的影响因素较多,男性、胎龄<39周、选择性剖宫产、胎粪吸入及母妊娠合并糖尿病均为其发生的危险因素。

Objective To investigate the influence factors of acute respiratory distress syndrome in the term infants. Methods Twenty seven cases of term infants with acute respiratory distress syndrome （ARDS） were enrolled in this retrospective studies, which were hospitalized in the NICU from January 2009 to Jan uary 2011. Logistic regression model was used to analyze the factors which affected the onset of ARDS. Results Incidence ratio of term infants with ARDS was 6.29%. The majority of onset time for ARDS was from 3 hours to 6 hours after birth （55.56%）. The main clinical characteristics were hypoxia and respira- tory distress, while the majority of level was Ⅲ level in chest X-ray （48.15%）. Logistic regression model showed that newborn gender, gestational age, mode of delivery, meeonium indrawing and gestational dia- betes mellitus were the risk factors （P 〈0.05）. Conclusion There are many factors affectes the onset and severity of ARDS. Male, gestational age less than 39 weeks, selective cesarean section and meeonium in- drawing and gestational diabetes mellitus are the risk factors for ARDS.