上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 专题报道（新生儿基础与临床研究） • 上一篇    下一篇

晚期早产儿与足月新生儿呼吸衰竭发生及预后的影响因素

朱天闻，张永红，陈 妍，夏红萍，赵冬莹，杨凌云，朱建幸   

  1. 上海交通大学  医学院附属新华医院新生儿科， 上海 200092
  • 出版日期:2013-07-28 发布日期:2013-08-22
  • 通讯作者: 朱建幸, 电子信箱: jxzhu@yahoo.cn。
  • 作者简介:朱天闻（1972—），女，主治医师，博士; 电子信箱: zhutianwen@hotmail.com。

Risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants

ZHU Tian-wen, ZHANG Yong-hong, CHEN Yan, XIA Hong-ping, ZHAO Dong-ying, YANG Ling-yun, ZHU Jian-xing   

  1. Department of Neonatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2013-07-28 Published:2013-08-22

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摘要：

目的 比较晚期早产儿与足月新生儿呼吸衰竭发生及预后的影响因素。方法 将新生儿重症监护室（NICU）收治的68例新生儿呼吸衰竭（NRF）患儿分为晚期早产儿组（n=34）和足月儿组（n=34），比较两组患儿的一般临床特征、围产期指标、呼吸衰竭治疗情况、主要疾病构成及预后评价；同时比较预后良好组与预后不良组之间临床和呼吸治疗指标的差异。结果 晚期早产儿组平均出生体质量显著低于足月儿组（P<0.01），且低体质量患儿比例显著高于足月儿组（P<0.05）；但两组间性别构成比、入NICU日龄和小于胎龄儿（SAG）比例差异均无统计学意义（P>0.05）。晚期早产儿组与足月儿组母亲的健康状况及其他围产期指标比较，差异均无统计学意义（P>0.05）。呼吸暂停仅见于晚期早产儿组，吸入NO治疗以及高频通气模式均发生于足月儿组；但两组间主要疾病构成、呼吸治疗方式及预后比较差异均无统计学意义（P>0.05）。预后良好组中SAG比例显著低于预后不良组，但剖宫产率显著高于预后不良组，差异均有统计学意义（P<0.05）。结论 NRF患儿胎龄与体质量的关系以及分娩方式是其预后的影响因素。

关键词: 晚期早产儿, 足月儿, 新生儿呼吸衰竭, 发生率, 预后, 危险因素

Abstract:

Objective To investigate the risk factors of prognosis of neonatal respiratory failure in late preterm and full-term infants. Methods Sixty-eight neonates with respiratory failure hospitalized in neonatal intensive care unit (NICU) were divided into late preterm infants group (n=34) and full-term infants group (n=34), the general clinical characteristics, perinatal parameters, treatment process of respiratory failure, main disease diagnosis and prognosis evaluation were compared between these two groups. Besides, the clinical parameters and respiratory parameters were compared between favorable prognosis group and unfavorable prognosis group. Results The average birth weight in late preterm infants group was significantly lower than that in full-term infants group (P<0.01), and the proportion of infants with low body weight in late preterm infants group was significantly higher than that in full-term infants group (P<0.05). However, there was no significant difference in the gender constituent ratio, age at NICU admission and proportion of infants small for gestational age between two groups (P>0.05). There was no significant difference in the healthy status and other perinatal parameters between late preterm infants group and full-term infants group (P>0.05). Apnea was only found in late preterm infants group, and NO inhalation treatment and high frequency ventilation were only adopted in full-term infants group, while there was no significant difference in the main disease diagnosis, respiratory treatment modality and prognosis between two groups (P>0.05). The proportion of infants small for gestational age in favorable prognosis group was significantly lower than that in unfavorable prognosis group (P<0.05), while the Caesarean section rate in favorable prognosis group was significantly higher than that in unfavorable prognosis group (P<0.05). Conclusion Relationship between gestational age and body weight of neonates with respiratory failure and way of delivery are influencing factors of prognosis.

Key words: late preterm infant, full-term infant, neonatal respiratory failure, incidence, prognosis, risk factor