171例早产儿呼吸窘迫综合征高危因素及临床分析

High-Risk Factors and Clinical Analysis on 171 Cases of Respiratory Distress Syndrome in Premature Infants

目的比较不同胎龄新生儿呼吸窘迫综合征(RDS)的临床特点、可能的高危因素及预后情况。方法选择2012年11月至2015年3月收治入院的171例RDS新生儿,其中早期早产儿99例,晚期早产儿52例,足月新生儿20例。回顾性分析RDS新生儿的基本情况、围生期相关因素、临床特点及预后。结果 171例RDS中,发病和入院年龄随胎龄减少、出生体质量减轻均有增加趋势,组间差异具有统计学意义(P<0.05)。3组新生儿高危因素分析,出生窒息和新生儿并发症均以早期早产儿最多,晚期早产儿次之。3组新生儿中,足月儿的肺表面活性物质(PS)应用剂量早期和晚期早产儿组之间比较差异无统计学意义,但是均显著低于足月患儿(P<0.05);3组RDS新生儿母亲在产前地塞米松使用率比较具有统计学意义(P<0.05)。患儿并发症主要有颅内出血、肺炎、视网膜病变和动脉导管未闭。3组新生儿治愈率比较无统计学意义(P>0.05),但早期早产儿死亡2例。结论不同胎龄、不同出生体质量RDS新生儿的临床特征、高危因素、并发症及治疗反应均存在差异,因此,在诊断和治疗时需要综合考虑各方面因素。

Objective To compare the clinical characteristics, potential high -risk factor and prog- nosis on respiratory distress syndrome（RDS） in premature infants. Methods From November 2012 to March 2015,171 RDS neonates were collected. Of them, there were 99 cases of early premature newborn,52 cases of advanced premature newborn and 20 cases of full - month newborn. The retrospective analysis was done on the basic condition, the relevant factors in prenatal period, clinical characteristics and prognosis of RDS neo- nates. Results In 171 cases of RDS, the occurrence of RDS and hospital stay age were increased with the re- duction of gestational age and body weight on born. The cases of birth asphyxia and complications were the highest among the early premature newborn and higher among the advanced premature newborn. In the three groups, the dosage of pulmonary surface active substance （PS）was not different significantly between the early premature newborn group and the advanced premature newborn group, but it was significantly lower than that in the full - month newborn group（ P 〈0. 05 ）. The utilization rate of dexamethasone before birth was significantly different among the three groups（ P 〈 0.05 ）. The complications included intraeranial hemorrhage, pul- monary infection, retinopathy and patent ductus arteriosus. The curative rate was not statistically significant a- mong the three groups （ P 〉0. 05 ）. There were 2 eases of death in early premature newborn. Conclusion The clinical characteristics, the high - risk factors, the complications and treatment reactions are differences in RDS neonates among different gestational age and newborn body weight mass. Hence, the comprehensive factors need to be considered in diagnosis and treatment.