目的 比较不同胎龄组新生儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的高危因素和治疗、预后情况,探讨不同胎龄组新生儿RDS临床特征的差异,为及时诊断和预防提供依据。 方法 2011年1月1日-12月31日符合RDS诊断标准的135例RDS患儿根据胎龄不同分为早期早产儿组(<34周)75例,晚期早产儿组(34~36+6周)33例,足月儿组(≥37周)27例,分别对各组患儿的发病率、基本情况、围生期高危因素、临床特点、治疗、预后情况等进行统计分析。 结果 RDS的发病率早产儿占多数;不同胎龄组RDS均以男婴发病率高;发病高危因素有各自的特点:早产儿主要有胎膜早破、不明原因早产、多胎妊娠、出生窒息等;晚期早产儿RDS与多胎妊娠、急诊剖宫产相关;糖尿病、剖宫产,尤其是产程未发动的择期剖宫产对足月儿RDS的发病起主要作用。足月儿病情重,多为“白肺”样改变,而且使用机械通气比例明显增多,易发生气胸。 结论 RDS在不同胎龄阶段发病特点、高危因素、治疗反应与并发症方面均存在差异,其诊治需要考虑胎龄因素的影响。择期剖宫产对于足月儿RDS发病起主要作用,临床上应严格掌握剖宫产指征。
关键词
呼吸窘迫综合征 /
胎龄 /
新生儿 /
婴儿
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