[1]唐烁,包蕾.新生儿急性呼吸窘迫综合征临床特征与预后相关因素分析[J].第三军医大学学报,2019,41(09):898-902.
 TANG Shuo,BAO Lei.Clinical characteristics and prognosis-related factors of neonatal acute respiratory distress syndrome[J].J Third Mil Med Univ,2019,41(09):898-902.
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新生儿急性呼吸窘迫综合征临床特征与预后相关因素分析(/HTML )
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《第三军医大学学报》[ISSN:1000-5404/CN:51-1095/R]

卷:
41卷
期数:
2019年第09期
页码:
898-902
栏目:
临床医学
出版日期:
2019-05-15

文章信息/Info

Title:
Clinical characteristics and prognosis-related factors  of neonatal acute respiratory distress syndrome
作者:
唐烁包蕾
重庆医科大学附属儿童医院新生儿科,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆市儿童发育重大疾病诊治与预防国际科技合作基地
 
Author(s):
TANG Shuo BAO Lei

Department of Neonatology, Key Laboratory of Child Development and Disorder of Ministry of Education, Chongqing Key Laboratory of Pediatrics, Chongqing International Science and Technology Cooperation Base for Child Development and Critical Disorders, Children’s Hospital of Chongqing Medical University, Chongqing, 400014, China

关键词:
急性呼吸窘迫综合征新生儿预后氧指数
Keywords:
acute respiratory distress syndrome neonates prognosis oxygenation index
分类号:
R181.32; R563.8; R722.19
文献标志码:
A
摘要:

目的探讨新生儿急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床特征及影响其预后的相关因素。方法回顾性分析2017年重庆医科大学附属儿童医院新生儿重症监护病房收治的呼吸衰竭1 018例患儿病历,其中参照蒙特勒标准诊断ARDS 204例。分析、探讨本组新生儿ARDS的临床特征,寻找影响ARDS预后的相关因素。结果 ①胎龄24周至27+6周早产儿12例(5.9%),胎龄28周至31+6周早产儿49例(24%),胎龄32周至36+6周早产儿70例(34.3%),足月儿73例(35.8%);出生体质量(2 260±898)g;男性127例(62.3%);Apgar评分5 min≤7分 42例(20.7%);败血症94例(46.1%),其中早发型败血症85例。轻度137例(67.2%)、中度49例(24.0%)、重度18例(8.8%),不同程度组间比较单纯无创通气、辅助通气时间及住院时间差异有统计学意义(P<0.05)。②好转治愈163例(79.9%)、放弃治疗死亡(放弃死亡)41例(20.1%),不同预后组比较,单因素分析发现与预后相关的变量有胎龄、出生体质量、Apgar评分5 min(P<0.05),多因素Logistic回归分析显示,胎龄为新生儿ARDS预后的独立影响因素。结论胎龄、出生体质量、Apgar评分5 min是影响新生儿ARDS预后的重要因素。

Abstract:

ObjectiveTo investigate the clinical characteristics of neonatal acute respiratory distress syndrome (ARDS), and the factors influencing its prognosis. MethodsClinical data of 1 018 cases suffering from respiratory failure admitted to the neonatal intensive care unit (NICU) of our hospital during the year of 2017 were collected and retrospectively analyzed. Among them, 204 cases were diagnosed as neonatal ARDS according to the Montreux definition. The clinical data of these 204 neonatal ARDS patients were retrospectively analyzed. Results①There were 12 preterm infants (5.9%) with gestational age of 24 weeks to 27 weeks + 6 d, 49 preterm infants (24.0%) with gestational age of 28 weeks to 31 weeks + 6 d, 70 preterm infants (34.3%) with gestational age of 32 weeks to 36 weeks + 6 d, and 73 fullterm infants (35.8%). The infants had an average birth weight of 2 260±898 g, with the male ratio of 62.3% (127 cases). Among them, 42 cases (20.7%) got 5 min Apgar score≤7 points. There were 94 cases (46.1%) suffering from sepsis, including 85 cases with earlyonset sepsis. According to oxygen index, the 204 ARDS infants were assigned into mild (n=137, 67.2%), moderate (n=49, 24.0%) and severe (n=18, 8.8%) groups, and significant differences were seen in the ratio of noninvasive ventilation, time of assisted ventilation and length of hospital stay among the groups (P<0.05). ② Among the 204 cases, 163 cases (79.9%) got improved or cured, and 41 cases (20.1%) were abandoned or dead. For different prognosis groups, univariate analysis found that gestational age, birth weight, and 5 min Apgar score were related to prognosis (P<0.05). Multivariate logistic regression analysis showed that gestational age was an independent influencing factor for neonatal ARDS prognosis. ConclusionGestational age, birth weight and 5 min Apgar score are pivotal factors for the prognosis of neonatal ARDS.

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更新日期/Last Update: 2019-05-08