新生儿呼吸窘迫综合征肺表面活性物质重复应用的情况及其高危因素研究

Study on the Repeated Application Situation of Pulmonary Surfactant of Newborns with Respiratory Distress Syndrome and its High Risk Factors

目的研究新生儿呼吸窘迫综合征肺表面活性物质重复应用的情况及其高危因素。方法选取2012年5月—2016年11月期间中山大学附属第一医院东院的96例呼吸窘迫综合征患儿为研究对象,将其肺表面活性物质重复应用率进行统计,然后比较不同出生情况(早产儿及足月儿)、治疗情况(分娩方式、首剂量及首次用药时间)及其他情况(伴发疾病情况、窒息情况、疾病分级、妊娠期高血压及妊娠期糖尿病情况)患儿的重复应用率,并采用logistic回归分析上述研究因素与此类患儿肺表面活性物质重复应用的关系。结果 96例呼吸窘迫综合征患儿中共有32例重复应用肺表面活性物质,重复应用率为33.33%,其中早产儿、剖宫产、首剂量较低、首次用药时间较长、伴发其他疾病、窒息、疾病分级较高、妊娠期高血压及妊娠期糖尿病患者的重复应用率均高于足月儿、顺产、首剂量较高、首次用药时间较短、未伴发其他疾病、未窒息、疾病分级较低、无妊娠期高血压及妊娠期糖尿病者,差异有统计学意义(P均<0.05)。且经logistic回归分析显示,上述因素均是新生儿呼吸窘迫综合征肺表面活性物质重复应用的危险因素。结论新生儿呼吸窘迫综合征肺表面活性物质重复应用率较高,且出生情况(早产儿及足月儿)、治疗情况(分娩方式、首剂量及首次用药时间)及其他情况(伴发疾病情况、窒息情况、疾病分级、妊娠期高血压及妊娠期糖尿病情况)均是其重复应用的高危因素,应根据此种情况进行针对性干预与预防。

Objective To study the repeated application situation of pulmonary surfactant of newborns with respiratory distress syndrome and its high risk factors. Methods 96 newborns with respiratory distress syndrome in the hospital from May,2012 to November,2016 were selected as the study object,and the repeated application rate of pulmonary surfactant of all the newborns was analyzed. The repeated application rates of newborns with different birth condition（ preterm infants and full-term infants）,treatment situation（ delivery modes,nitial dose and first medication time） and other situation（ concomitant disease situation,asphyxia situation,disease classification,gestational hypertension and gestational diabetes mellitus situation） were compared,then the relationship between those study factors and repeated application situation of pulmonary surfactant of newborns with respiratory distress syndrome were analyzed by logistic regression analysis. Results 32 cases of 96 newborns with respiratory distress syndrome got repeated application of pulmonary surfactant. The repeated application rate was 33. 33%,and the repeated application rates of newborns with preterm infants,cesarean section,lower initial dose,longer first medication time,concomitant other disease,asphyxia,higher disease classification,gestational hypertension and gestational diabetes mellitus were all higher than those of newborns with full-term infants,natural labour,higher nitial dose,shorter first medication time,without concomitant other disease,asphyxia,lower disease classification,without gestational hypertension and gestational diabetes mellitus. There was statistical significance（ P〈0. 05）. Logistic regression analysis showed that those factors were all the risk factors of repeated application of pulmonary surfactant of newborns with respiratory distress syndrome. Conclusion The repeated application rate of pulmonary surfactant of newborns with respiratory distress syndrome is higher. The birth condition（ preterm infants and full-term infants）,treatment situation（ delivery modes,initial dose and first medication time） and other situation（ concomitant disease situation,asphyxia situation,disease classification,gestational hypertension and gestational diabetes mellitus situation） are the high risk factors of repeated application of pulmonary surfactant,so they should be paid to more intervention and prevention according to the situation.