Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and th...Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and these characteristics have not been well documented as yet. This study was to investigate the pathogenesis, clinical characteristics and management strategies of RDS in full-term neonates, with the aim of developing a working protocol for improving the outcome in full-term neonates with RDS. Methods A total of 125 full-term infants with RDS were enrolled in this study. Their clinical and laboratory data were collected for analyzing the characteristics of full-term neonatal RDS. Results （1） The 125 cases included 94 male and 31 female infants, vaginal delivery occurred in 80 cases and cesarean section in 45 cases. （2） The onset time of RDS was （3.11±3.59） hours after birth. （3）The possible reasons included severe perinatal infections in 63 patients, elective cesarean section in 34 cases, severe birth asphyxia in 12 patients, meconium aspiration syndrome in 9 patients, pulmonary hemorrhage in 4 patients and maternal diabetes in 3 patients. （4） Complications included multiple organ system failure （MOSF） in 49 patients, persistent pulmonary hypertension of newborn （PPHN） in 25 patients, acute renal failure in 18 patients, severe hyperkalemia in 25 patients, severe metabolic acidosis in 6 cases, severe myocardial injury in 9 cases, pulmonary hemorrhage in 3 cases, disseminated intravascular coagulation in 14 patients and shock in 12 patients.（5） Four patients died, the mortality was therefore 3.2% with the main cause of septicemia complicating of MOSF, but their prognosis was improved while comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were taken into account. Conclusions RDS is not an uncommon disease in full-term infants and is associated with a higher mortality, its clinical characteristics are very different from展开更多
目的比较早期应用无创高频振荡通气(nasal high frequency oscillatory ventilation,nHFOV)与经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)作为早产儿呼吸窘迫综合征(respiratory distress syndrome,RDS)初...目的比较早期应用无创高频振荡通气(nasal high frequency oscillatory ventilation,nHFOV)与经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)作为早产儿呼吸窘迫综合征(respiratory distress syndrome,RDS)初始治疗的临床效果。方法选取在新生儿重症监护病房(neonatal intensive care unit,NICU)住院治疗的86例RDS早产患儿,随机分为nHFOV组(n=44)及nCPAP组(n=42)。分析比较两组患儿初始治疗失败率、呼吸支持治疗相关数据、病死率及各种不良反应发生的情况。结果nHFOV组初始治疗失败率、BPD发生率、总通气时间、治疗后二氧化碳分压(partial pressure of carbon dioxide,PaCO2)均明显低于nCPAP组,差异有统计学意义(P<0.05);而两组治疗后氧分压(partial pressure of oxygen,PaO2)、病死率、无创通气时间以及新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)、早产儿视网膜病(retinopathy of prematurity,ROP)、颅内出血(intraventricular hemorrhage,IVH)、消化道穿孔、气胸/气漏及鼻损伤等不良反应发生率差异无统计学意义(P>0.05)。结论作为RDS早产儿的初始治疗方式,nHFOV临床治疗效果优于nCPAP,而各种不良反应发生率较nCPAP低或相当,可作为一种新的无创通气方式在临床使用。展开更多
基金This work was supported by the grants from China Postdoctoral Science Foundation （No. 20080431405＆ No. 200801041）.
文摘Background Respiratory distress syndrome （RDS） is one of the most common causes of neonatal respiratory failure and neonatal death, however, its clinical characteristics are very different from premature RDS, and these characteristics have not been well documented as yet. This study was to investigate the pathogenesis, clinical characteristics and management strategies of RDS in full-term neonates, with the aim of developing a working protocol for improving the outcome in full-term neonates with RDS. Methods A total of 125 full-term infants with RDS were enrolled in this study. Their clinical and laboratory data were collected for analyzing the characteristics of full-term neonatal RDS. Results （1） The 125 cases included 94 male and 31 female infants, vaginal delivery occurred in 80 cases and cesarean section in 45 cases. （2） The onset time of RDS was （3.11±3.59） hours after birth. （3）The possible reasons included severe perinatal infections in 63 patients, elective cesarean section in 34 cases, severe birth asphyxia in 12 patients, meconium aspiration syndrome in 9 patients, pulmonary hemorrhage in 4 patients and maternal diabetes in 3 patients. （4） Complications included multiple organ system failure （MOSF） in 49 patients, persistent pulmonary hypertension of newborn （PPHN） in 25 patients, acute renal failure in 18 patients, severe hyperkalemia in 25 patients, severe metabolic acidosis in 6 cases, severe myocardial injury in 9 cases, pulmonary hemorrhage in 3 cases, disseminated intravascular coagulation in 14 patients and shock in 12 patients.（5） Four patients died, the mortality was therefore 3.2% with the main cause of septicemia complicating of MOSF, but their prognosis was improved while comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were taken into account. Conclusions RDS is not an uncommon disease in full-term infants and is associated with a higher mortality, its clinical characteristics are very different from
文摘目的比较早期应用无创高频振荡通气(nasal high frequency oscillatory ventilation,nHFOV)与经鼻持续气道正压通气(nasal continuous positive airway pressure,nCPAP)作为早产儿呼吸窘迫综合征(respiratory distress syndrome,RDS)初始治疗的临床效果。方法选取在新生儿重症监护病房(neonatal intensive care unit,NICU)住院治疗的86例RDS早产患儿,随机分为nHFOV组(n=44)及nCPAP组(n=42)。分析比较两组患儿初始治疗失败率、呼吸支持治疗相关数据、病死率及各种不良反应发生的情况。结果nHFOV组初始治疗失败率、BPD发生率、总通气时间、治疗后二氧化碳分压(partial pressure of carbon dioxide,PaCO2)均明显低于nCPAP组,差异有统计学意义(P<0.05);而两组治疗后氧分压(partial pressure of oxygen,PaO2)、病死率、无创通气时间以及新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)、早产儿视网膜病(retinopathy of prematurity,ROP)、颅内出血(intraventricular hemorrhage,IVH)、消化道穿孔、气胸/气漏及鼻损伤等不良反应发生率差异无统计学意义(P>0.05)。结论作为RDS早产儿的初始治疗方式,nHFOV临床治疗效果优于nCPAP,而各种不良反应发生率较nCPAP低或相当,可作为一种新的无创通气方式在临床使用。
