早产儿肺透明膜病发病高危因素分析

目的:分析与早产儿肺透明膜病(hyaline membrane disease,HMD)发病相关的高危因素,以探讨有效的防治措施.方法:回顾性分析102例早产儿HMD的临床资料,包括胎龄、出生体重、性别、生后窒息程度、产前应用肾上腺皮质激素(激素)、母亲合并症、分娩方式、使用肺表面活性物质(pulmonary surfactant,PS)情况、双胎或多胎儿等,采用统计学方法分析与HMD发病相关的因素.结果:影响HMD发生的高危因素为胎龄、出生体重、性别、重度窒息、产前应用激素、母亲合并症,优势比分别为0.985、1.138、1.193、2.305、2.386、2.698(均为P＜0.05);HMD发病与分娩方式、使用肺表面活性物质与否、双胎或多胎儿等无关(均为P＞0.05);使用PS未降低HMD的发生率,但明显降低其严重程度,缩短机械通气、高浓度用氧时间,增加体重.结论:加强围生期保健,减少孕母产期合并症和早产儿、极低出生体重儿的发生率,避免早产儿产时、产后窒息缺氧,适当采用促胎肺成熟药物,是降低早产儿HMD发生率与病死率的关键措施.

Analysis of high risk factors on the morbidity of premature infants with hyaline membrane disease

Objective:To study the high risk factors related with the morbidity in hyaline membrane disease(HMD) of premature infants, in order to obtain the effective measure for prevention and treatment. Methods:102 HMD cases were analyzed in terms of the relationships among HMD and gestational age, birth weight, sex, asphyxia, antenatal steroid therapy, mother with complication, delivery way, pulmonary surfactant (PS) application, and twin. Results:The morbidity of premature infants with HMD were closely related to gestational age, birth weight, sex, severe perinatal asphyxia, antenatal steroid therapy and mother with complication, The odds ratio were 0.985, 1.138, 1.193, 2.305, 2.386, 2.698(P< 0.05).There were no relationships among HMD and delivery way, PS application(P>0.05). PS application did not decrease the morbidity but decrease the severity of the disease, shorter ventilation and high oxygen concentration time, increase the body weight. Conclusion:To enhance prenatal monitor, lower the morbidity of premature especially very low birth weight infant (VLBWI), and the use of antenatal steroid therapy properly, are the most important measures for preventing HMD.