新生儿急性呼吸窘迫综合征相关影响因素分析

Analysis of incidence rate and related factors of neonatal acute respiratory distress syndrome

目的分析新生儿急性呼吸窘迫综合征(NRDS)相关影响因素。方法选择该院2015年6月至2017年7月收治的44例NRDS新生儿作为病例组,选取同期44例入院未发生NRDS新生儿作为对照组。回顾性分析比较两组一般资料、临床症状、实验室指标、影像学特征、危险因素。结果对照组各项指标均为正常。病例组新生儿常见临床表现为呻吟、血钙及血钾异常,大部分X线片可见支气管充气征、斑片影、双肺透过度低。两组剖宫产、出生窒息、吸入羊水、低血糖、宫内窘迫、胎膜早破、感染、产前应用糖皮质激素、产后应用肺表面活性物质、1 min Apgar评分比较,差异有统计学意义(P<0.05),其中剖宫产(OR=4.09)、出生窒息(OR=4.67)、吸入羊水(OR=5.17)、宫内窘迫(OR=3.24)为NRDS发病的危险因素。结论剖宫产、出生窒息、吸入羊水和宫内窘迫是NRDS发病危险因素。

Objective To investigate the incidence rate and related factors of neonatal acute respiratory distress syndrome(NRDS).Methods Forty-four NRDS neonatus admitted to the hospital from June 2015 to July 2017 were selected as the observation group,44 neonatus without NRDS were selected as the control group.Retrospective analysis was used to compare the two groups of general data,clinical symptoms,laboratory indicators,imaging features,risk factors.Results All the indicators in the control group were normal.The common clinical manifestations of the observation group were moaning,abnormal blood calcium and potassium,most of whom were found bronchial inflation sign,patchy shadow and low lung permeability in X-ray.The proportion of caesarean section,birth asphyxia,inhalation of amniotic fluid,hypoglycemia,intrauterine distress,premature rupture of membranes,infection,application of prenatal glucocorticoid,application of postpartum pulmonary surfactant,and 1 minute Apgar score were significantly different between the two groups(P<0.05).Cesarean section(OR=4.09),birth asphyxia(OR=4.67),inhalation of amniotic fluid(OR=5.17),intrauterine distress(OR=3.24)were the risk factors for NRDS.Conclusion The incidence of NRDS is affected by cesarean section,birth asphyxia,inhalation of amniotic fluid and intrauterine distress.