晚期早产儿呼吸窘迫综合征高危因素及临床特点分析

目的 比较早、晚期早产儿呼吸窘迫综合征(RDS)的特点,探讨晚期早产儿RDS的高危因素和临床特点.方法 选择2014年1月至2015年1月在该院住院240例早产儿RDS,根据胎龄分为两组,<34周为早期早产儿组(143例),34~36+6为晚期早产儿组(97例).回顾性分析早产儿RDS的基本情况、围生期高危因素、临床特点、治疗及预后.结果 晚期早产儿组分娩方式以剖宫产为主,剖宫产率达83.51%,明显高于早期早产儿组(P<0.05).晚期早产儿组因先兆子宫破裂行剖宫产致早产的发生率较高(27.84%);肺表面活性剂(PS)及无创辅助通气治疗效果较早期早产儿差,且机械通气率高,通气时间长;肺动脉高压发生率、宫内感染的发生率亦高于早期早产儿组(P<0.05).结论 晚期早产儿RDS以产程未发动的剖宫产为主,宫内感染可能为其高危因素,PS应用有效,但较早期早产儿效果差;晚期早产儿机械通气率较高,但预后良好.

Analysis of high-risk factors and clinical characteristics of respiratory distress syndrome in late preterm infants

Objective To compare the characteristics of respiratory distress syndrome(RDS) between early preterm infants and late preterm(LP) infants,and to investigate the high-risk factors and clinical characteristics of RDS in LP infants.Methods A total of 240 premature infants with RDS treated in our hospital from January 2014 to January 2015 were selected and divided into 2 groups according to the gestational age(GA),143 cases in early preterm group (GA <34 weeks) and 97 cases in LP group(GA 34-36 weeks).The basic situation,high risk factors in perinatal period,clinical characteristics,treatment and prognosis in RDS premature infants were retrospectively analyzed.Results The delivery mode in the LP group was mainly dominated by cesarean section,the cesarean section rate reached 83.51%,which was significantly higher than that in the early preterm group (P<0.05).The premature occurrence rate caused by cesarean section because of premonitory uterine rupture was higher (27.84%);the treatment effect of pulmonary surfactant(PS) and noninvasive assisted ventilation therapy in the LP group was inferior to that in the early premature group,moreover the mechanical ventilation rate was higher,the duration of mechanical ventilation was longer;the incidence rates of pulmonary hypertension and intrauterine infection were higher than those in the early preterm group.Conclusion LP infants with RDS are mainly dominated by cesarean section without onset of labor process,intrauterine infection may be its risk factor,PS use is effective,but its effect is more poor than that in the early preterm group,the mechanical ventilation rate in the LP group is higher,but the prognosis is good.