新生儿呼吸窘迫综合征发病危险因素分析及预防对策
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摘要
目的探讨新生儿呼吸窘迫综合征(NRDS)的发病危险因素及预防NRDS的对策,以期降低临床NRDS率,提高母儿安全。方法选择南充市中心医院2014年12月-2017年12月期间发病的90例NRDS新生儿及孕妇作为研究对象设为观察组,按照1∶2的配比选择180例同期在本院生产的正常新生儿及孕妇作为对照组。对两组孕妇基本情况(年龄、产次、胎数、妊娠期高危因素、分娩方式、胎膜早破、宫内窘迫、分娩窒息等)及新生儿基本情况(性别、胎龄、体质量、羊水胎粪污染、宫内感染等)的不同水平进行卡方分析。将组间差异有统计学意义的因素纳入多因素Logistic系统进行危险因素分析。根据Logistic结果探讨预防NRDS的措施。结果两组孕妇在年龄、多胎、分娩方式、不良孕产史、生殖道感染、合并高血压疾病、合并糖尿病、指征剖宫产、宫内窘迫、分娩窒息、妊娠期高危妊娠因素、胎膜早破、宫内窘迫、分娩窒息、新生儿性别、胎龄、体质量、羊水胎粪污染及宫内感染发生率差异有统计学意义(P<0. 05)。经Logistic分心显示,经Logistic分心显示,多胎、指征剖宫产、合并高血压疾病、合并糖尿病、不良孕产史、宫内窘迫、分娩窒息、新生儿男性、胎龄<34周、体质量<2 000 g、妊娠期宫内感染、羊水胎粪污染是NRDS的高危因素,差异有统计学意义(P<0. 05)。结论导致NRDS危险因素较多,临床应对有NRDS高危因素的产妇做好产前评估,采取针对性的措施,预防NRDS的发生,同时做好NRDS的抢救预案,提升NRDS的预后水平。
Objective to analyze the risk factors of neonatal respiratory distress syndrome( NRDS) and explore the countermeasures to prevent NRDS,in order to reduce the clinical NRDS rate and improve the safety of mother and child. Methods 90 cases of NRDS neonates and pregnant women in this hospital in December 2014-2017 December were selected as the study group,and the observation group was selected as the research group. According to the ratio of 1:2,180 cases of normal neonates and pregnant women who were born in our hospital in the same period were selected as the control group. The basic situation of the two groups of pregnant women( age,parity,birth number,pregnancy risk factors,mode of delivery,premature rupture of membranes,fetal distress,birth asphyxia etc.) and neonatal situation( gender,gestational age,body weight,meconium stained amniotic fluid,intrauterine infection) chi square analysis of different levels. The factors of statistically significant differences were included in the multifactor Logistic system for risk factors analysis. According to the results of Logistic,the measures to prevent NRDS were discussed. Results the two groups of pregnant women in age,multiple pregnancy,childbirth,adverse pregnancy history,reproductive tract infections,hypertension,diabetes mellitus,cesarean section, Miyamauchi Sako,pregnancy,birth asphyxia,premature rupture of high-risk pregnancy factors,fetal distress,birth asphyxia,neonatal sex,gestational age,body quality,meconium stained amniotic fluid,the incidence of intrauterine infection was statistically significant( P < 0. 05). The Logistic display Logistic display distraction,distraction,multiple pregnancy,cesarean section,hypertension,diabetes,abnormal pregnancy,childbirth,newborn asphyxia,Miyamauchi Sako male,gestational age < 34 weeks,body weight is less than 2000 g,pregnancy,intrauterine infection,meconium stained amniotic fluid is a risk factor of NRDS( P< 0. 05). Conclusion there are many risk factors for NRDS. We should take the measures to prevent the occurrence of NRDS,and take the rescue plan for NRDS to improve the prognosis of NRDS. We should take measures to prevent the occurrence of NRDS.
Objective to analyze the risk factors of neonatal respiratory distress syndrome( NRDS) and explore the countermeasures to prevent NRDS,in order to reduce the clinical NRDS rate and improve the safety of mother and child. Methods 90 cases of NRDS neonates and pregnant women in this hospital in December 2014-2017 December were selected as the study group,and the observation group was selected as the research group. According to the ratio of 1:2,180 cases of normal neonates and pregnant women who were born in our hospital in the same period were selected as the control group. The basic situation of the two groups of pregnant women( age,parity,birth number,pregnancy risk factors,mode of delivery,premature rupture of membranes,fetal distress,birth asphyxia etc.) and neonatal situation( gender,gestational age,body weight,meconium stained amniotic fluid,intrauterine infection) chi square analysis of different levels. The factors of statistically significant differences were included in the multifactor Logistic system for risk factors analysis. According to the results of Logistic,the measures to prevent NRDS were discussed. Results the two groups of pregnant women in age,multiple pregnancy,childbirth,adverse pregnancy history,reproductive tract infections,hypertension,diabetes mellitus,cesarean section, Miyamauchi Sako,pregnancy,birth asphyxia,premature rupture of high-risk pregnancy factors,fetal distress,birth asphyxia,neonatal sex,gestational age,body quality,meconium stained amniotic fluid,the incidence of intrauterine infection was statistically significant( P < 0. 05). The Logistic display Logistic display distraction,distraction,multiple pregnancy,cesarean section,hypertension,diabetes,abnormal pregnancy,childbirth,newborn asphyxia,Miyamauchi Sako male,gestational age < 34 weeks,body weight is less than 2000 g,pregnancy,intrauterine infection,meconium stained amniotic fluid is a risk factor of NRDS( P< 0. 05). Conclusion there are many risk factors for NRDS. We should take the measures to prevent the occurrence of NRDS,and take the rescue plan for NRDS to improve the prognosis of NRDS. We should take measures to prevent the occurrence of NRDS.
引文
[1]杨燕玲,单若冰.重度新生儿呼吸窘迫综合征死亡危险因素分析[J].中国小儿急救医学,2014,21(7):423-426.
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[4]荣辉.INSURE技术与传统机械通气治疗新生儿窘迫综合征的临床疗效对比[J].中国妇幼保健,2018,33(9):2038-2041.
[5]刘凤,吴明赴,王飞,等.89例足月新生儿呼吸窘迫综合征危险因素分析[J].中国妇幼保健,2016,31(21):4449-4451.
[6]Edwards MO,Kotecha SJ,Kotecha S.Respiratory distress of the term newborn infant[J].Paediatr Respir Rev,2013,14(1):29-36.
[7]王君.早产儿呼吸窘迫综合征的危险因素分析及糖皮质激素的治疗价值探讨[J].国际呼吸杂志,2014,34(13):1001-1004.
[8]Pramatarova T,Marinov B,Slancheva B,et al.Respirtory distress in newborns of mothers with factor V-Leiden thrombophilia[J].Akush Ginekol(Sofiia),2013,52(4):21-24.
[9]Alkan S,Ozer EA,Ilhan O,et al.Surfactant treatment for neonatal respiratory disorders other than respiratory distress syndrome[J].JMatern Fetal Neonatal Med,2015,28(2):131-133.
[10]吴翼君,余静,管利荣等.导致新生儿呼吸窘迫综合征的危险因素分析[J].当代医药论丛,2015,31(12):218-219.
[11]彭宇波,叶志其.足月新生儿呼吸窘迫综合征发病的危险因素分析[J].中国伤残医学,2014,25(9):66-68.
[12]葛书霞,谢淑霞,车伟坤,等.新生儿呼吸窘迫综合征高风险因素分析[J].中华实用诊断与治疗杂志,2015,29(5):516,518.
[13]徐艳,张文辉,刘文强,等.新生儿呼吸窘迫综合征不良预后临床高危因素分析[J].中国综合临床,2017,33(2):171-174.
[14]杨雪,赵旭晶.不同胎龄新生儿呼吸窘迫综合征的临床特征及相关危险因素分析[J].中国妇幼保健,2017,32(17):4157-4160.
[15]李敏,刘晓琳.足月新生儿呼吸窘迫综合征危险因素分析[J].安徽医学,2016,37(3):330-332.
[2]Reuter S,Moser C,Baack M.Respiratory distress in the newborn[J].Pediatr Rev,2014,35(10):417-428.
[3]麻伟博.新生儿呼吸窘迫综合征发病危险因素的Logistic回归分析[J].中华肺部疾病杂志(电子版),2016,9(2):182-184.
[4]荣辉.INSURE技术与传统机械通气治疗新生儿窘迫综合征的临床疗效对比[J].中国妇幼保健,2018,33(9):2038-2041.
[5]刘凤,吴明赴,王飞,等.89例足月新生儿呼吸窘迫综合征危险因素分析[J].中国妇幼保健,2016,31(21):4449-4451.
[6]Edwards MO,Kotecha SJ,Kotecha S.Respiratory distress of the term newborn infant[J].Paediatr Respir Rev,2013,14(1):29-36.
[7]王君.早产儿呼吸窘迫综合征的危险因素分析及糖皮质激素的治疗价值探讨[J].国际呼吸杂志,2014,34(13):1001-1004.
[8]Pramatarova T,Marinov B,Slancheva B,et al.Respirtory distress in newborns of mothers with factor V-Leiden thrombophilia[J].Akush Ginekol(Sofiia),2013,52(4):21-24.
[9]Alkan S,Ozer EA,Ilhan O,et al.Surfactant treatment for neonatal respiratory disorders other than respiratory distress syndrome[J].JMatern Fetal Neonatal Med,2015,28(2):131-133.
[10]吴翼君,余静,管利荣等.导致新生儿呼吸窘迫综合征的危险因素分析[J].当代医药论丛,2015,31(12):218-219.
[11]彭宇波,叶志其.足月新生儿呼吸窘迫综合征发病的危险因素分析[J].中国伤残医学,2014,25(9):66-68.
[12]葛书霞,谢淑霞,车伟坤,等.新生儿呼吸窘迫综合征高风险因素分析[J].中华实用诊断与治疗杂志,2015,29(5):516,518.
[13]徐艳,张文辉,刘文强,等.新生儿呼吸窘迫综合征不良预后临床高危因素分析[J].中国综合临床,2017,33(2):171-174.
[14]杨雪,赵旭晶.不同胎龄新生儿呼吸窘迫综合征的临床特征及相关危险因素分析[J].中国妇幼保健,2017,32(17):4157-4160.
[15]李敏,刘晓琳.足月新生儿呼吸窘迫综合征危险因素分析[J].安徽医学,2016,37(3):330-332.