新生儿呼吸窘迫综合征流行病学特点及影响因素分析

Epidemiological characteristics and influencing factors of neonatal respiratory distress syndrome

目的探讨新生儿呼吸窘迫综合征的流行病学特点及影响因素.方法将120例新生儿呼吸窘迫综合征患儿设为观察组,214名健康新生儿设为对照组.收集两组新生儿的资料,分析新生儿呼吸窘迫综合征的流行病学特点及影响因素.结果 观察组多为男性早产儿,体质量多为1.5 kg—2.4 kg,胎龄多为29周—35周,并发症排名前3位的依次为感染、呼吸暂停、动脉导管未闭.宫内窒息或窘迫、羊水吸入、胎膜早破、宫内感染、产后窒息、产后应用肺表面活性物质、早产、多胎妊娠、妊娠期糖尿病、脐带异常、胎盘异常、剖宫产、产前应用糖皮质激素是新生儿呼吸窘迫综合征的影响因素(P<0.01).回归分析显示,宫内窒息或窘迫、剖宫产、妊娠期糖尿病、早产、羊水吸入、产后窒息是新生儿呼吸窘迫综合征的独立危险因素(P<0.05),胎膜早破、产后应用肺表面活性物质、产前应用糖皮质激素是新生儿呼吸窘迫综合征的保护因素(P<0.05).结论宫内窒息或窘迫、剖宫产、妊娠期糖尿病、早产、羊水吸入、产后窒息是新生儿呼吸窘迫综合征的独立危险因素,临床应尽早明确上述因素,有助于指导临床鉴别诊断、选用治疗方案及判断预后效果.

Objective To analyze the epidemiological characteristics and influencing factors of neonatal respiratory distress syndrome.Methods 120 cases of neonatal respiratory distress syndrome were set as the observation group,and 214 healthy newborns were set as the control group.Collect data from two groups of newborns to analyze the epidemiological characteristics and influencing factors of NRDS.Results Most of the observation group were male premature babies with body weights ranging from 1.5 kg to 2.4 kg and gestational age ranging from 29 weeks to 35 weeks.The top three complications were infection,apnea,and patent ductus arteriosus.Intrauterine asphyxia or distress,amniotic fluid inhalation,premature rupture of membranes,intrauterine infection,postpartum asphyxia,postpartum application of pulmonary surfactant,preterm delivery,multiple pregnancy,gestational diabetes,umbilical cord abnormalities,abnormal placenta,cesarean section,prenatal application of glucocorticoids were influencing factors of neonatal respiratory distress syndrome(P<0.01).Regression analysis showed that intrauterine asphyxia or distress,cesarean section,gestational diabetes,premature delivery,amniotic fluid inhalation,and postpartum asphyxia were independent risk factors for neonatal respiratory distress syndrome(P<0.05).Premature rupture of membranes,application of pulmonary surfactant after delivery,and application of glucocorticoids before delivery were protective factors of neonatal respiratory distress syndrome(P<0.05).Conclusions Intrauterine asphyxia or distress,cesarean section,gestational diabetes,premature delivery,amniotic fluid inhalation,and postpartum asphyxia are independent risk factors for neonatal respiratory distress syndrome.The above factors should be clarified in the clinic as soon as possible,which can help guide the clinical differential diagnosis,select the treatment plan and judge the prognostic effect.