摘要
目的回顾性分析新生儿病房1998-2012年来诊断为新生儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的早产儿病例,总结在治疗措施方面的进展。方法回顾性病例对照研究,1998年1月-2012年12月本院新生儿重症监护病房(NICU)收治的<34周新生儿呼吸窘迫综合征早产儿病例,记录母孕期情况和围产期情况,出生史和采用呼吸支持方式(有创或无创呼吸支持),是否应用肺表面活性物质(pulmonary surfactant,PS),用药剂量以及患儿的合并症和结局。结果自1998年1月-2004年12月为A组,63例;2005年1月-2012年12月病例为B组,151例。B组患儿出生体重[(1 284.50±252.15)g]明显低于A组[(1 424.27±329.44)g](t=3.292,P<0.001),分娩前应用激素促进肺成熟的病例数明显增加(B组139例,92.1%;A组44例,69.8%;χ2=17.704,P<0.001);B组应用PS总量为(195.00±59.87)mg,A组中应用PS总量为(169.66±57.97)mg,两组间差异有统计学意义(P=0.041);计算PS与体重比值,B组为(147.71±42.09)mg/kg,A组为(115.86±37.11)mg/kg,差异显著(P<0.01)。B组85(70.8%)应用有创呼吸支持,较A组39例(90.7%),显著降低(χ2=6.86,P<0.01)。B组33例(27.5%)诊断支气管肺发育不良(BPD),较A组4例(9.3%)显著增高(χ2=5.97,P=0.02)。住院天数、NICU住院天数、氧疗天数都是B组显著长于A组。A组12例死亡,病死率27.9%,而B组14例死亡,病死率11.7%,两组比较差异有统计学意义(χ2=6.23,P=0.01)。结论在过去十余年来,随着分娩前应用激素促肺成熟及外源性表面活性物质的引入,采用适宜的呼吸支持方式,使越来越多的RDS早产儿得以存活。
Objective To study changes of treatment in preterm infants with respiratory distress syndrome （RDS） during 1998-2012. Methods Retrospective observational study of infants,〈34 weeks gestation,born between January 1998 and December 2012. A group was the cases during the first 7 years（n=63） ,and B group was the cases during the next 8 years （n = 151）. Perinatal data, birth history treatment （including respiratory support, surfactant therapy and doses）, complications and outcomes were compared. Results The birth weight of B group was （1 284.50±252. 153）g,significantly lower than A group [（1 424.27 ± 329.44）g] （t= 3. 292, P〈0. 001）. The amount of surfactant in group was （169.66±57.97） rag,significantly lower than that of B group [（195.00±59.87） mg]（P=0. 041）. The requirement of intubation ventilation support in A group was 39 cases （90.7 % ）, higher than 85 cases in B group （70.8 % ）（x^2 = 6.86, P〈0.01）. In group B,33 cases （27.5%） developed BPD,whicb was more than 4 cases （9.3%） in A group （x^2 =5.97,P=0.02）. The length of hospitalization, NICU stay and oxygen dependence in B group were longer than A group. The mortality of B group was lower than A group,11. 7% versus 27.9% （x^2 =6.23,P=0.01）. Conclusion In the last decades,exogenous surfactant replacement has been established as an effective and safe therapy in RDS preterm infants.
出处
《中国儿童保健杂志》
CAS
北大核心
2014年第4期416-419,共4页
Chinese Journal of Child Health Care
