目的 分析不同胎龄新生儿呼吸窘迫综合征（RDS）临床特征，为临床早期诊治提供线索。方法 将133 例RDS 患儿依据胎龄分为<34 周组（n=66）、34 周～组（晚期早产儿组，n=31）和37 周～组（足月儿组，n=36）。回顾性分析母孕期病史、新生儿出生时情况，对不同组别患儿临床资料进行对比分析。结果 胎龄<34 周组产前皮质激素使用率明显高于晚期早产儿组（P < 0.05）。胎龄<34 周组比足月儿组和晚期早产儿组的原发病率更低（P < 0.05），发生呼吸困难的时间更晚（P < 0.05），脑室内出血发生率更高（P < 0.05）。胎龄<34 周组血清白蛋白水平比足月儿组更低（P < 0.05）。足月儿组和晚期早产儿组的肺表面活性物质重复使用率高于胎龄 <34 周组（P < 0.05）。足月儿组高频振荡通气使用率高于胎龄<34 周组（P < 0.05）。结论 不同胎龄RDS 的临床特征不同，其RDS 发生机制可能也不同，管理策略也应有所不同。
Abstract
Objective To study clinical features of respiratory distress syndrome (RDS) in neonates of different gestational ages (GA). Methods According to GA, 133 neonates with RDS were classified into GA <34 weeks group (n=66), GA 34-36 weeks group (late preterm neonates; n=31), and GA ≥37 weeks group (full-term neonates; n=36). The mothers' medical history during pregnancy and the condition of the neonates at birth were retrospectively analyzed, and the clinical data were compared between groups. Results Prenatal corticosteroids supplementation in the GA <34 weeks group was more common than that in the GA 34-36 weeks group (P < 0.05). Compared with the GA ≥37 weeks group and the GA 34-36 weeks group, the GA <34 weeks group showed a significantly lower rate of primary diseases, a significantly later time of the development of dyspnea (P < 0.05), and a higher rate of intraventricular hemorrhage (P < 0.05). Serum albumin levels in the GA <34 weeks group were significantly lower than in the GA ≥37 weeks group (P < 0.05). The GA ≥37 weeks group and the GA 34-36 weeks group showed a significantly higher reuse rate of pulmonary surfactant (P < 0.05). Use of high-frequency oscillatory ventilation was more common in the GA ≥37 weeks group compared with the GA <34 weeks group (P < 0.05). Conclusions The clinical features of RDS are different across neonates of different GA, suggesting that the pathogenesis of RDS may be different in neonates of different GA.
关键词
呼吸窘迫综合征 /
临床特征 /
胎龄 /
新生儿
Key words
Respiratory distress syndrome /
Clinical feature /
Gestational age /
Neonate
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