海南省新生儿呼吸窘迫综合征流行病学调查分析

Epidemiological investigation and analysis of neonatal respiratory distress syndrome in Hainan

目的调查海南省新生儿呼吸窘迫综合征(NRDS)流行病学情况,为海南省NRDS预防措施制定提供参考,降低NRDS率,提升人口出生质量。方法收集整理海南省5家综合医院和2家妇产医院2014年1月-2017年1月间新生儿资料,统计NRDS发生率、新生儿情况:性别、胎龄、出生体质量、出生Apgar评分等情况。孕妇情况:年龄、胎次、高危妊娠及类型、分娩方式、是否阴道难产及难产类型(巨大儿、糖尿病、扁平骨盆、肩难产等)。按照是否为NRDS,将新生儿分为NRDS组和非NRDS组,采用病例对照组研究法,比较两组新生儿及孕妇上述指标的差异,分析海南省新生儿NRDS的影响因素及危险因素,了解NRDS患儿治疗情况及预后情况,探讨NRDS预防和治疗措施。结果海南省2014年1月-2017年1月纳入调查医院共出生新生儿32183例,NRDS 392例,NRDS率1. 22%。胎儿性别、出生体质量、胎龄、出生Apgar评分、胎数、胎次、高龄产妇、胎次、阴道难产、高危妊娠是影响NRDS的相关因素。经多因素Logistic分析,多胎、低体质量出生、胎龄≤35周、高龄产妇、阴道难产是NRDS危险因素。结论 NRDS预后差,产前对产妇及胎儿发生NRDS的危险因素评估,对于有NRDS危险因素的产妇做好产时应激预案,提升NRDS抢救质量。

Objective To investigate the epidemiology of neonatal respiratory distress syndrome(NRDS)in Hainan Province,so as to provide references for the formulation of NRDS prevention measures in Hainan Province,reduce the NRDS rate and improve birth quality.Methods The data of neonates in5general hospitals and2maternity hospitals in Hainan province from January2014to2017were collected,and the incidence of NRDS and neonatal situation such as gender,gestational age,birth weight and birth Apgar score were statistically analyzed.Pregnant women's age,parity,high-risk pregnancy and type,mode of delivery,whether vaginal dystocia and dystocia types(macrosomia,diabetes,flat pelvis,shoulder dystocia etc.)were analyzed.According to NRDS,the neonates were divided into the NRDS group and the non NRDS group,and the difference in above indexes were comparatively analyzed between the two groups,in order to screen the risk factors affecting NRDS in Hainan province,understand the treatment and prognosis of NRDS,and explore the prevention and treatment measures.Results32183cases of newborns were born in the survey hospital in Hainan province from January2014to2017,and there were392cases of NRDS.The rate of NRDS was1.22%.Fetal sex,birth weight,gestational age,birth Apgar score,birth number,parity,maternal age,parity,vaginal dystocia and high risk pregnancy were the related factors of NRDS.Multivariate logistic analysis showed multiple births,low birth weight,gestational age,maternal age less than35weeks,and vaginal dystocia were the risk factors.Conclusion The prognosis of NRDS is poor.The quality of NRDS rescue can be improved when the risk factors for NRDS in puerpera and fetuses are evaluated before delivery and the stress schedule is developed for the pregnant women.