不同胎龄新生儿呼吸窘迫综合征治疗及预后的比较分析

Teatment and prognosis of respiratory distress syndrome in neonates of different gestational ages

目的:比较早期早产儿与晚期早产儿、足月儿新生儿呼吸窘迫综合征的治疗方案及预后的不同,为新生儿呼吸窘迫综合征的治疗及并发症的防治提供依据。方法:回顾性分析122例新生儿呼吸窘迫综合征(RDS)患儿的临床资料,按胎龄分为两组:早期早产儿组(<34周)、晚期早产儿、足月儿组(≥34周),比较两组患儿的治疗方案和预后情况。结果:RDS患儿中早期早产儿所占比例较高(57.38%),发病早,肺泡表面活性物质(PS)使用率高,PS再次使用率高,n CPAP使用率高,使用n CPAP时间长,差异均有统计学意义(P<0.05)。早期早产儿合并支气管肺发育不良、消化道出血、败血症、喂养不耐受的发生率更高,而晚期早产儿、足月儿合并新生儿持续肺动脉高压的发生率更高,差异有统计学意义(P<0.05)。两组新生儿中,早期早产儿治愈率更低,死亡率更高,住院时间更长,差异有统计学意义(P<0.05)。结论:不同胎龄新生儿RDS的治疗方案和预后存在差异,在治疗时应考虑胎龄因素,做到早诊断、早治疗、减少并发症、降低死亡率。

Objective To compare the different treatment and prognosis of early preterm infants,late preterm infants and full term infants with respiratory distress syndrome and to provide a new basis for clinical therapy and complications prevent. Method 122 hospitalized neonates with RDS were selected and analyzed retrospectively,they were divided into 2 groups,early preterm（ GA 34 weeks）,late preterm and full term group（ GA ≥ 34 weeks）. Retrospectively analysis was performed for treatment and prognosis of the two groups. Results In 122 neonates with RDS,early preterm infants had a higher proportion（ 57. 38%）,a earlier onset time,a higher application rate of pulmonary surfactant,a higher rate of pulmonary surfactant application again,a higher application rate of n CPAP and a longer application time of n CPAP（ P〈0. 05）. The risks of complicated with bronchopulmonary dysplasia,gastrointestinal hemorrhage,septicemia and feeding intolerance were the higher in early preterm group and the risk of complicated persistent pulmonaryhypertension of the newborn was the higher in late preterm and full term group（ P〈0. 05）. Among the two groups,the early preterm group had the lower recovery rate,a higher mortality rate and a longer hospitalization time（ P〈0. 05）. Conclusion The treatment and responses of RDS in neonates with different GA are different,so GA should be considered for treatment to accomplish early diagnosis,early treatment,reduce the incidence of complications and mortality rate.