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目的 探讨重症胎粪吸入综合征 (MAS)患儿的临床与死亡相关因素 ,以利进一步降低重症MAS的病死率。方法 对 1993～ 1996年间上海新华医院、上海医科大学儿科医院、北京儿童医院等 9家医院收治的 81例重度MAS患儿的资料进行分析 ,应用SAS统计软件 ,对死亡因素进行秩和检验及 χ2 检验。结果 81例患儿中死亡 32例 ,病死率 39 5 %。胎龄、1分钟Apgar评分及多种并发症如持续肺动脉高压、缺血缺氧性脑病和气胸的发生与死亡密切相关 (P <0 0 5 )。结论 2 0世纪 90年代中期重症MAS的较高病死率 (接近 40 % )提示 ,对常规分娩时的复苏吸引和单纯通气效果应进一步进行评估。
Objective To investigate the clinical and mortality-related factors in children with severe meconium aspiration syndrome (MAS) in order to further reduce the mortality of severe MAS. Methods The data of 81 severe MAS patients admitted to Shanghai Xinhua Hospital, Shanghai Medical University Pediatric Hospital and Beijing Children’s Hospital from 1993 to 1996 were analyzed. The SAS test was used to rank the risk factors for death and Chi2 test. Results 81 cases of children died of 32 cases, the mortality rate 39 5%. The gestational age, 1-minute Apgar score and various complications such as persistent pulmonary hypertension, hypoxic-ischemic encephalopathy and pneumothorax were closely related to death (P <0.05). Conclusions The higher case fatality (nearly 40%) of severe MAS in the mid-1990s suggests that the induction of resuscitation and simple ventilation should be further evaluated during routine labor.