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内蒙古部分地区新生儿呼吸窘迫综合征诊治现状的多中心调查分析

Multicenter investigation and analysis of neonatal respiratory distress syndrome in parts of Inner Mongolia
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摘要 目的通过收集与分析内蒙古地区新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的临床资料,探讨内蒙古地区NRDS的发病特点、诊治现状和结局。方法回顾性分析内蒙古地区4家医院(西部地区内蒙古医科大学附属医院、包钢三医院、鄂尔多斯市中心医院3家医院,东部地区赤峰学院附属医院1家医院)新生儿病房于2016年1月1日零点至2018年6月30日24点诊断为NRDS的所有患儿,收集全部病例的一般情况、围生期情况、临床表现及治疗、并发症及出院预后情况,进行统计分析。结果参与调查的4家医院研究期间共收治11406例新生儿,NRDS患儿748例,占新生儿收治总数的6.56%,其中东部地区NRDS患儿279例,收治比率9.30%,西部地区NRDS患儿469例,收治比率5.58%。东部地区NRDS患儿的平均住院时间长于西部地区、母亲年龄高于西部地区,差异均有统计学意义(P<0.05);西部地区产前激素使用、剖宫产、多胎、胎膜早破、低Apgar评分比例均高于东部地区(P<0.05);东部地区NRDS分级Ⅰ级及Ⅲ级比例、肺泡表面活性物质(pulmonary surfactant,PS)使用率、INSURE技术使用率高于西部地区;NRDSⅡ级比例、第一次使用PS剂量西部地区高于东部地区(P<0.05)。NRDS患儿总病死率6.15%(46/748),动脉导管未闭、支气管肺发育不良、坏死性小肠结肠炎、呼吸机相关性肺炎的发生率西部地区均高于东部地区(P<0.05)。结论内蒙古东西部地区4家医院NRDS诊治水平高低不一,相比其他地区存在产前糖皮质激素治疗率低、PS及INSURE技术使用不足、PS使用时间晚等问题。NRDS的救治应继续规范产前糖皮质激素治疗、尽早足量使用PS、推广使用INSURE技术。 Objective To investigate the diagnosis and treatment status of neonatal respiratory distress syndrome(NRDS)in Inner Mongolia and explore the problems and countermeasures for NRDS diagnosis and treatment.Methods Data of infants with NRDS in 4 hospitals(3 hospitals were in the west,which were the Affiliated Hospital of Inner Mongolia Medical University,Baotou Steel Three Hospital and Ordos Central Hospital,1 hospital was in the east,which was the Affiliated Hospital of Chifeng Institute)participating in the study during the period from 1th January,2016 to 30th June,2018 were investigated retrospectively with descriptive epidemiological survey,including basic situation,perinatal period,clinical manifestations,treatment,complications and prognosis.Results Among 11 406 newborns admitted in 4 hospitals during the study period,748 infants were diagnosed with NRDS,accounting for 6.56%.In the eastern region,279 infants were diagnosed with NRDS,the rate was 9.30%,and in the western region were 469(5.58%).The average hospitalization time in the eastern region was longer than that in the western region,and the age of mothers was higher than that in the western region.There were significant differences between the two groups(P<0.05).The antenatal hormone use,cesarean delivery,multiple gestation,low Apgar score,premature rupture of membrane in the western region were higher than those in the eastern region(P<0.05).The proportion of NRDS grade Ⅰ and gradeⅢ,pulmonary surfactant(PS)utilization ratio and INSURE technology usage in the eastern region were higher than those in the western region.The ratio of NRDS(grade Ⅱ)and the first dose of PS in the western region were higher than those in the eastern region(P<0.05).The total mortality of neonates with NRDS was 6.15%(46/748).The incidence rates of patent ductus arteriosus,bronchopulmonary dysplasia,necrotizing enterocolitis,ventilator-associated pneumonia in the western region were higher than those in the eastern region(P<0.05).Conclusion The level of diagnosis and treatme
作者 宋丹 梅花 谢华 何海英 杨宇萍 Song Dan;Mei Hua;Xie Hua;He Haiying;Yang Yuping(Department of Neonatology,Affiliated Hospital,Inner Mongolia Medical University,Hohhot 010050,China;Department of Neonatology,Chifeng Institute Affiliated Hospital,Chifeng 024000,China;Department of Neonatology,Baotou Steel Three Hospital,Baotou 014010,China;Department of Neonatology,Ordos Central Hospital,Ordos 017000,China)
出处 《中国小儿急救医学》 CAS 2019年第2期107-112,共6页 Chinese Pediatric Emergency Medicine
基金 内蒙古自然科学基金面上项目(2016MS(LH)0804) 内蒙古自然科学基金面上项目(2015MS(LH)0810)。
关键词 新生儿 呼吸窘迫综合征 流行病学 Neonates Respiratory distress syndrome Epidemiology
作者简介 宋丹,对本文有同等贡献;通信作者:梅花,Email:meihuayani@sina.com,对本文有同等贡献;谢华,对本文有同等贡献;何海英,对本文有同等贡献;杨宇萍,对本文有同等贡献.
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