摘要
Abstract
Objective To analyze the clinical characteristics of respiratory distress syndrome(RDS)in neonates with different gestational age.Methods Altogether 145 neonates with RDS hospitalized in neonatal department in Shaanxi People's Hospital and Xi'an Northern Hospital from January 2013 to January 2017 were divided into early preterm birth group(gestational age< 34 weeks,n=70),late preterm birth group(gestational age 34—37 weeks,n=35),and full—term birth group(gestational age>37 weeks,n= 40)according to different gestational age.Pregnancy conditions of puerpera and neonatal situation at birth were retrospectively analyzed and compared.Results Neonates with gestational age <34 weeks accounted for 48.3%(70/145),34—37 weeks accounted for 24.1%(35/145)and >37 weeks 27.6%(40/145).Antenatal corticosteroids supplementation in early preterm birth group was obviously more than that in late preterm birth group and full-term group(χ2early preterm birth group vs late preterm birth group=6.61, P<0.05;χ2early preterm birth group vs full-term birth group=25.79,P<0.05),and ALB level in early preterm birth group was significantly lower than that in full-term group(qearly preterm birth group vs full-term birth group=9.80,P<0.05),and proportion of neonates with primary disease in early preterm birth group was lower than that in full —term group(χ2early preterm birth group vs full-term birth group=11.39,P<0.01).Pairwise comparison showed that dyspnea occurring time in early preterm birth group was significantly earlier than that in late preterm birth group and full-term group, and the difference had statistical significance(qearly preterm birth group vs late preterm birth group= 2.77, qearly preterm birth group vs full-term birth group=2.81,both P<0.05),but the differences in pH,ratio of oxygen partial pressure and fraction of inhaled oxygen(PaO2/FiO2)among three groups were not statistically significant(all P> 0.05).Pulmonary surfactant(PS) repeat utilization rate in late preterm birth group and full-term group was significantly higher than that in early preterm birth group (χ2full-term birth group vs early preterm birth group=7.54,χ2full-term birth group vs late preterm birth group=4.97,both P<0.05).Continuous positive airway pressure (CPAP) utilization rate in full-term group was significantly higher than that in late preterm birth group (χ2full-term birth group vs late preterm birth group=7.44,P<0.05),and high frequency oscillation ventilation(HFOV)utilization rate in full-term group was significantly higher than that in early preterm birth group(χ2full-term birth group vs early preterm birth group= 6.89, P < 0.05). Intraventricular hemorrhage(IVH)incidence in early preterm birth group was obviously higher than that in late preterm birth group and full-term group(χ2early preterm birth group vs late preterm birth group= 4.25,χ2early preterm birth group vs full-term birth group= 7.34,both P < 0.05). Conclusion Main pathogenesis of RDS in neonates with different gestational age is defect of pulmonary surfactant,but clinical characteristics of neonatal RDS in different gestational age are different,and treatment methods also have differences.关键词
新生儿呼吸窘迫综合征/胎龄/临床特征/回顾性分析Key words
neonatal respiratory distress syndrome/gestational age/clinical characteristics/retrospective analysis分类
医药卫生
