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目的:分析我院新生儿病房新生儿呼吸窘迫综合征(NRDS)的临床特征。方法:收集我院新生儿病房2007年11月至2013年10月收治的1 379例NRDS患儿的临床资料,依次以每12个月为1个时段,进行回顾性分析。结果:1 379例NRDS患儿中早产儿占71.57%,男女比例1∶0.52。6个时段NRDS患儿在同期住院患儿中所占比例依次为3.24%、2.20%、3.18%、3.80%、4.07%、3.71%。常见高危因素有剖宫产(74.33%)、胎膜早破(21.97%)及宫内窘迫(18.35%)。首次胸片改变Ⅰ级占29.22%,Ⅱ级占32.41%,Ⅲ级占30.38%,Ⅳ级占7.98%。产前激素、肺表面活性物质(PS)、辅助通气使用率分别为21.61%、62.51%、93.11%。住院时间中位数为14 d。治愈好转率67.73%,病死率3.34%,放弃治疗28.93%。并发颅内出血52.14%、呼吸机相关性肺炎27.99%。结论:NRDS患儿在住院患儿中所占比例呈上升趋势,以早产儿为主,男性比例较高;剖宫产是NRDS目前最常见的高危因素,应谨慎评估实施剖宫产术的必要性;首次胸片改变以Ⅱ~Ⅲ级为主;PS及辅助通气是NRDS主要治疗措施;并发症以颅内出血为主。
Objective: To analyze the clinical features of neonatal respiratory distress syndrome (NRDS) in neonatal wards in our hospital. Methods: The clinical data of 1 379 children with NRDS admitted to neonatal ward of our hospital from November 2007 to October 2013 were collected. The data were retrospectively analyzed in one cycle every 12 months. Results: 1 379 NRDS children accounted for 71.57% of premature children, male to female ratio of 1:0.52.6 NRDS children in the same period accounted for 3.24%, 2.20%, 3.18%, 3.80% 4.07%, 3.71%. Common risk factors are cesarean section (74.33%), premature rupture of membranes (21.97%) and intrauterine distress (18.35%). For the first time, the change of gradeⅠwas 29.22%, grade Ⅱ 32.41%, grade Ⅲ 30.38% and grade Ⅳ 7.98%. Prenatal hormones, pulmonary surfactant (PS) and assisted ventilation were 21.61%, 62.51% and 93.11% respectively. The median length of stay was 14 days. Cure rate of 67.73% improvement, mortality was 3.34%, to give up treatment of 28.93%. 52.14% of intracranial hemorrhage, ventilator-associated pneumonia 27.99%. Conclusion: The proportion of children with NRDS in infants tends to increase, especially in preterm infants. The proportion of males is higher. Cesarean section is the most common risk factor of NRDS at present. Careful assessment of the necessity of cesarean section should be carried out ; The first change of chest radiographs was grade Ⅱ ~ Ⅲ; PS and assisted ventilation were the main treatment measures of NRDS; The complication was mainly intracranial hemorrhage.