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目的:分析与早产儿肺透明膜病(hyalinemembranedisease,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(pulmonarysurfactant,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。
Objective: To analyze the risk factors related to the pathogenesis of hyalinemembranedisease (HMD) in premature infants to explore effective prevention and treatment measures. Methods: The clinical data of 102 preterm infants with HMD were retrospectively analyzed, including gestational age, birth weight, sex, degree of postnatal asphyxia, prenatal application of corticotropin (hormone), maternal complications, mode of delivery, use of pulmonary surfactant (pulmonarysurfactant, PS), twins or fetuses and so on, using statistical methods to analyze the factors associated with the incidence of HMD. Results: The risk factors for HMD were gestational age, birth weight, sex, severe asphyxia, prenatal steroid and maternal complications, and the odds ratios were 0.985,1.138,1.193,2.305,2.386,2.698 (all P <0.05 ); The incidence of HMD and mode of delivery, the use of pulmonary surfactant or not, twins or multiple fetuses had nothing to do (all P> 0.05); the use of PS did not reduce the incidence of HMD, but significantly reduce the severity and shorten the mechanical ventilation , High concentration of oxygen time, increase body weight. Conclusion: To strengthen the perinatal care, reduce maternal complications and premature children, very low birth weight infants, to prevent preterm birth, postpartum asphyxia and hypoxia, the appropriate use of fetal growth-promoting drugs is to reduce preterm birth Children HMD incidence and mortality of the key measures.