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目的:探讨晚期早产儿和足月儿呼吸窘迫综合征(RDS)的临床特点,为临床合理诊治提供依据。方法:回顾性分析2010年1月~2011年6月期间在我科住院的197例RDS患儿的临床资料。按胎龄分为两组,≤35周为早产儿组,146例,>35周为晚期早产儿和足月儿组,51例。结果:晚期早产儿和足月儿组入院时龄11.8 h,晚于早产儿组(2.7 h),P<0.01;择期剖宫产出生率72.5%,高于早产儿组的36.3%;应用呼吸机治疗的比例(76.5%)高于早产儿组(61.0%),P<0.05;开始应用呼吸机的时间(16.2 h)迟于早产儿组(8.3 h),P<0.01;总的治愈率(96.1%)大于早产儿组(82.2%),P<0.01;并发气胸的比例(11.8%)略高于早产儿组(6.2%),但无明显统计学差异(P>0.05),并发PPHN较早产儿组多,并发颅内出血和肺炎较早产儿组少。结论:晚期早产儿和足月儿RDS临床上并不少见,发病高危因素主要为择期剖宫产,入院时间较晚,临床症状较严重,需要应用呼吸机治疗的病例较多,易并发PPHN,应引起重视。
Objective: To investigate the clinical features of respiratory distress syndrome (RDS) in advanced premature infants and term infants and to provide evidence for clinical diagnosis and treatment. Methods: The clinical data of 197 RDS children hospitalized in our department from January 2010 to June 2011 were retrospectively analyzed. Divided into two groups according to gestational age, ≤ 35 weeks for the preterm children group, 146 cases,> 35 weeks for advanced premature children and term infants, 51 cases. Results: The incidence of cesarean section in late preterm infants and term infants was 11.8 h later than that in preterm infants (2.7 h) (P <0.01). The elective cesarean section rate was 72.5%, higher than that of preterm infants (36.3% (76.5%) was higher than that of premature infants (61.0%), P <0.05; the time of starting ventilator was 16.2 h later than that of premature infants (8.3 h), P <0.01; the total cure rate (P <0.01). The proportion of pneumothorax (11.8%) was slightly higher than that of premature infants (6.2%), but there was no significant difference (P> 0.05) More preterm children group, complicated by intracranial hemorrhage and pneumonia than premature children less. Conclusion: RDS in late preterm and term infants is not uncommon. The risk factors of etiology are mainly elective cesarean section, late admission and severe clinical symptoms. There are many cases requiring ventilator to treat PPDS, Should pay attention.