摘要
目的了解国内住院分娩早产儿呼吸窘迫综合征（respiratory distress syndrome,RDS）的发生率、病死率、并发症特点、发生高危因素、产前激素应用对早产儿RDS的发生率及预后的影响。方法收集国内13家医院2014年1月1日至12月31日住院分娩的24周≤胎龄〈37周的全部早产儿共7684例。前瞻性分析RDS发生率、病死率、并发症、发生高危因素及产前应用地塞米松的效果。结果活产出生新生儿共75 360例,其中早产儿7 684例（其中入院早产儿6604例,非入院1080例）,早产儿发生率为10.2%。其中极早产儿957例,占12.5%;超早产儿92例,占1.2%。发生RDS 1 177例,发生率为15.3%。24周≤胎龄〈25周、25周≤胎龄〈26周、26周≤胎龄〈27周、27周≤胎龄〈28周、28周≤胎龄〈29周、29周≤胎龄〈30周、30周≤胎龄〈31周、31周≤胎龄〈32周、32周≤胎龄〈33周、33周≤胎龄〈34周、34周≤胎龄〈35周、35周≤胎龄〈36周、36周≤胎龄〈37周早产儿RDS发生率分别为100.0%、90.0%、85.0%、85.1%、81.0%、74.3%、55.4%、47.1%、33.1%、17.9%、9.6%、5.0%、1.9%。出生体重〈500 g、500~749 g、750~999 g、1 000~1 499 g、1 500~2 499 g、2 500~4 000 g、〉4 000 g早产儿RDS的发生率分别为100.0%、100.0%、79.2%、55.8%、15.0%、3.6%、9.5%。RDS早产儿病死率为10.5%,其中胎龄24周≤胎龄〈25周、25周≤胎龄〈26周、26周≤胎龄〈27周、27周≤胎龄〈28周、28周≤胎龄〈29周、29周≤胎龄〈30周、30周≤胎龄〈31周、31周≤胎龄〈32周、32周≤胎龄〈33周、33周≤胎龄〈34周、34周≤胎龄〈35周、35周≤胎龄〈36周、36周≤胎龄〈37周早产儿RDS病死率,分别为100%、70.0%、23.5%、20.0%、16.2%、10.3%、8.1%、9.6%、8.9%、6.0%、5.5%、8.8%、4.5%。RDS患儿颅内出血（ICH）、早产儿视网膜病（ROP）、支气管肺发育不良（BPD）、坏死性小肠结肠炎（NEC）、动脉导管未闭（PDA）、肺出血及败血症的发�
Objective To investigate the morbidity, mortality, characteristics of the complications, high risk factors and the effects of antenatal corticosteroids on the morbidity and prognosis of respiratory distress syndrome in inborn preterm neonates in China. Method Data were collected from January 1, 2014 to December 31, 2014 for premature with gestational age 37 weeks born in Obstetric. The morbidity, mortality, characteristics of the complications, high risk factors, effect of antenatal corticosteroids were analysis retrospectively. Results From a total of 75 360 live birth newborns, there were 7 684 cases（10.2%） of preterm neonates, of which 957 cases（12.5%） were extreme prematurity and 92 cases（1.2%） were severe/moderate prematurity. Of these preterm neonates, a total of 1 177 were classified as RDS（15.3%）. The morbidity of RDS in neonates with 24≤GA25、25≤GA26、26≤GA27、27≤GA28、28≤GA29、29≤GA30、30≤GA31、31≤GA32、32≤GA33、33≤GA34、34≤GA35、35≤GA36 and36≤GA37 weeks were 100.0%、90.0%、85.0%、85.1%、81.0%、74.3%、55.4%、47.1%、33.1%、17.9%、9.6%、5.0% and 1.9%, respectively. The morbidity of RDS in preterm neonates with BW500,500-749, 750-999, 1 000-1 499, 1 500-2 499, 2 500-4 000 and more than 4 000 grams were 100.0%,100.0%,79.2%, 55.8%, 15.0%, 3.6% and 9.5%, respectively. The mortality of preterm neonates with RDS was 10.5%. The mortality of RDS in neonates with 24≤GA25、25≤GA26、26≤GA27、27≤GA28、28≤GA29、29≤GA30、30≤GA31、31≤GA32、32≤GA33、33≤GA34、34≤GA35、35≤GA36 and 36≤GA37 weeks were 100.0%,70.0%, 23.5%, 20.0%, 16.2%, 10.3%, 8.1%, 9.6%, 8.9%, 6.0%, 5.5%, 8.8% and 4.5%, respectively. The incidence of ICH, ROP, BPD, NEC, PDA, pulmonary hemorrhage and sepsis in preterm neonates with RDS were higher than those without RDS. Logistic regressions showed that male, GA33 weeks, BW2 500 grams, body length 40 cm, neonatal asphyxia production time≥2 times, and placenta praevia were risk factors for RDS. Multiple pregn
作者
徐凤丹
段顺艳
孔祥永
封志纯
张珊
吴鸿雁
吕红艳
杨李红
吴素静
巨容
汪瑾
彭立
李占魁
赵小林
曾淑娟
丘惠娴
温伟溪
武辉
李莹
李楠
贾文峥
张雪峰
郭果
刘卫鹏
王凤
李改梅
刘芳
李薇
赵晓英
程红斌
许云波
陈文超
尹欢
丁艳洁
王晓亮
单瑞艳
陈铁强
许平
韩梅盈
杨春燕
XU Feng-dan DUAN Shun-yan KONG Xiang-yong FENG Zhi-chun ZHANG Shan WU Hong-yan Lü Hong-yan YANG Li-hong WU su-jing JU rong WANG jin PENG Li LI Zhan-kui ZHAO Xiao-lin ZENG Shu-juan QIU Hui-xian WEN Wei-xi WU Hui LI Ying LI Lan JIA Wen-zheng ZHANG Xue-feng GUO Guo LIU Wei-peng WANG Feng LI Gai-mei LIU Fang LI Wei ZHAO Xiao-ying CHENG Hong-bin XU Yun-bo CHEN Wen-chao YIN Huan DING Yan-jie WANG Xiao-liang SHAN Rui-yan CHEN Tie-qiang XU Ping HAN Mei-ying YANG Chun-yan(Multicenter collaborative team for the study of RDS in preterm neonates in urban of China,Department of Pediatrics, Guang Dong Medical University,Department of Pediatrics, Ba Yi Children’s Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital of Southern Medical University,Department of Pediatrics,Handan maternity and child care centers,Neonatal Intensive Care Unit, Chengdu Women ＆ Children’s Central Hospital,Neonatal Intensive Care Unit,Shanxi Maternal and Child Care Service Centre,Neonatal Intensive Care Unit, Longgang District Central Hospital of Shenzhen,Department of Pediatrics, First Hospital of Jilin University,Department of Pediatrics, 302 Military Hospital of China,Department of Pediatrics, Navy General Hospital,Department of Pediatrics, Bethene International Peace Hospital,Department of Neonatology, Huangshi Maternal and Child Health Hospital,Department of Pediatrics,Yantai Yuhuangding Hospital,Department of Pediatrics, Changsha Hospital for Maternal and Child Health Care,Department of Pediatrics, Liaocheng People’s Hospital)
出处
《发育医学电子杂志》
2016年第2期106-118,共13页
Journal of Developmental Medicine (Electronic Version)
关键词
早产儿
呼吸窘迫综合征
产前激素
前瞻性调查分析
Preterm birth
Respiratory distress syndrome
Antenatal corticosteroids
Prospective study
