早产儿发生呼吸窘迫综合征及患儿宫外发育迟缓的相关因素分析

Analysis on the relevant factors of respiratory distress syndrome and extrauterine growth restriction for premature infants

目的分析早产儿发生呼吸窘迫综合征相关因素及呼吸窘迫综合征早产儿宫外发育迟缓的危险因素。方法选择呼吸窘迫综合征早产儿153例作为病例组,根据是否发生宫外发育迟缓分为EUGR组和非EUGR组,选择同期非呼吸窘迫综合征早产儿200例作为对照组,观察各组临床资料,分析相关因素。结果呼吸窘迫综合征患儿与非呼吸窘迫综合征患儿EUGR及严重EUGR发生率差异均有统计学意义(P<0.05)。胎龄、出生体重、多胎率、预防性应用PS率、产前激素应用率、宫内窘迫或窒息、羊水吸入、宫内感染、前置胎盘/胎盘早剥、剖宫产、妊娠期高血压病、妊娠期糖尿病发生率是早产儿发生呼吸窘迫综合征的相关因素(P<0.05)。胎龄<31周、多胎、达全量肠内营养时间、喂养不耐受、恢复出生体重时间是呼吸窘迫综合征早产儿EUGR独立危险因素(P<0.05),产前激素应用是呼吸窘迫综合征早产儿EUGR保护因素(P<0.05)。结论胎龄小和多胎是早产儿发生呼吸窘迫综合征及患儿EUGR的共同危险因素,产前激素应用对两者都有一定的保护作用,呼吸窘迫综合征对患儿宫外发育有明显不良影响,呼吸窘迫综合征早产儿EUGR主要与喂养情况有关。

Objective To analyze the relevant factors of respiratory distress syndrome for premature infants and the risk factors of extrauterine growth restriction（EUGR）for the premature infants with respiratory distress syndrome. Methods All 153 premature infants with respiratory distress syndrome were selected as case group, and they were assigned to EUGR group and non-EUGR group on the basis of whether they had EUGR. 200 premature infants without respiratory distress syndrome were selected as control group during the same period. Clinical data of each group were observed and relevant factors were analyzed. Results Differences of incidence rates of EUGR and severe EUGR between the pre-mature infants with respiratory distress syndrome and those without respiratory distress syndrome were statistically sig-nificant （P〈0.05）. Incidence rates of gestational age, birth weight, multiple pregnancy rate, preventive application rate of PS,antenatal application rate of hormone,fetal distress or asphyxia,amniotic fluid aspiration,intrauterine in-fection, placenta previa/placental abruption, cesarean section, pregnancy-induced hypertension and ges tational dia-betes mellitus were relevant factors of respiratory distress syndrome for premature infants （P〈0.05）. Gestational age of less than 31 weeks, multiple pregnancy, time reaching total enteral nutrition, feeding intolerance, and time resuming birth weight were independent risk factors of EUGR for premature patients with respiratory distress syndrome （P〈0.05）. Antenatal application of hormone was the protective factor of EUGR for premature infants with respiratory dis-tress syndrome （P〈0.05）. Conclusion Young gestational age and multiple pregnancy are common risk factors of respi-ratory distress syndrome and EUGR for premature infants, and antenatal application of hormone has protective effect on the two diseases. Respiratory distress syndrome has obvious adverse effect on infants＇ extrauterine growth, and EU-GR for premature infants with respiratory distress syndrome is mainly related to feeding.