选择性剖宫产与晚期早产儿呼吸窘迫综合征的研究进展

Respiratory distress syndrome in late preterm neonates delivered by elective cesarean section

晚期早产儿的呼吸系统发育尚未完全成熟，因此和足月儿相比有更高的呼吸窘迫综合征发病率。随着选择性剖宫产率在世界范围内的迅速增加，选择性剖宫产和晚期早产儿呼吸窘迫综合征的关系越来越引起重视。临床资料显示，选择性剖宫产会导致晚期早产儿呼吸窘迫综合征发病率显著增加。其主要因为肺液排除延迟，吸收不良，导致肺泡表面活性物质浓度稀释，达不到生物学效应，肺泡萎陷。与早期早产儿相比，晚期早产儿发生呼吸窘迫综合征往往症状出现迟，肺泡表面活性物质效果不理想，如治疗不及时，易发生其他并发症。因此，对于晚期早产儿呼吸窘迫综合征的防治应尽可能经阴道分娩，一旦出现呼吸窘迫综合征症状，应早期诊断、及时救治。

Late preterm neonates have immature respiratory systems and higher incidence of respiratory distress syndrome compared with term neonates. With the increase rate of elective cesarean section world- wild, the association between elective cesarean section and late preterm neonates respiratory distress syndrome has attracted a huge attention. Clinical data have showed that the incidence of respiratory distress syndrome was significantly increased in late preterm neonates delivered by elective cesarean section. The delay of lung fluid movement dilutes the concentration of pulmonary surfactant and causes the alveolar collapse. Compared with early preterm neonates, the respiratory distress syndrome of late preterm neonates appears later with a worse reaction of pulmonary surfactant and higher incidence of complications. Thus, vaginal delivery of late preterm neonates is the optimal choice and early diagnosis and therapy of respiratorv distress syndrome is very important.