早产儿重症湿肺的临床高危因素研究

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1、早产儿重症湿肺的临床高危因素研究蒋莉胡毓华崔曙东金蕊朱亮华通讯作者南京医科大学第一附属医院儿科南京210036基金项目:国家自然科学基金青年基金(81300023);国家自然科学基金(81170661);江苏省自然科学基金青年基金(BK20131020);江苏高校优势学科建设工程(jX10231081);教育部点基金(20113234110010)基金名称新生儿医学中新:FXK201212目的研究早产儿重症湿肺的临床特征及影响治疗的高危因素.方法回顾性分析新生儿重症监护室收治的2(5例早产重症湿肺患儿，分为无创通气组和有创通气组，统计两组患儿的断脐时间、

2、Apgar评分、血气分析检测结果以及疗效转归的情况.结果26例早产儿中无创呼吸组8例，有创呼吸组18例.无创呼吸组的断脐时间显著长于有创通气组，两组患儿入院时均存在不同程度的血气改变，有创通气组更显著.与无创通气组对比，有创通气组的症状好转时间、住院时间长,住院病死率高.结论早产儿重症湿肺以剖宫产多见,多合并多种并发症,适当延迟断脐时间、掌握机械通气时机对于早产重症湿肺患儿的整体情况及呼吸循环功能有显著改善.【关键词】早产儿；湿肺；机械通气ClinicalstudiesonseriouswetlungofprematurenewbornJiangLi'H

3、uYu—hua'CuiShu—dong,JinRui,ZhuLiang—hua.ThefirstaffiliatedhospitalofNanjingMedicalUniversity,Nanjing,210036,China.[Abstract]ObjectiveToresearchtheclinicalfeaturesofseriouswetlungofprematurenewbornandtoidentifyhigh—riskfactorsfortreatment.Methods26casesofprematurenewbornwithseriou

4、swetlunginNICUwereretrospectivelystudied,andweredividedintononinvasiveventilationgroupandinvasiveventilaGtiongroup.Comparedthetwogroupswithumbilicalcordcuttingtimings,Apgarscore,arterialbloodgasandassessmentofcurativeeffect.ResuItTherewere8newbornsinnoninvasiveventilationgroupand

5、18ininvasiveventilationgroup.UmbilicalcordcuttingtimingofnoninvasiverespiratorygroupwassignificantlylonGgerthaninvasiveventilationgroup.BothoftwogroupsvariedinABG,whileinvasiveventilationgroupwasmoresignificant.ComparedwithnoninvasiveventilaGtiongroup,disappearanceofsymptomsandho

6、spitalstayininvasiveventilationgroupwerelonger,andhigherincasefatalityrate.ConclusionSeriouswetlungissignificantlyassociatedwithcesareansectioninprematurenewborn?withavarietyofcomplications.DelayingumbilicalcordcuttingtimingandappropriaterespirGatorysupportwillbebenefittotheprema

7、turenewbornoverallsituationandrespiratoryfunction.【Keywords】Prematurenewborn;Wetlung;Machanicalventilation【中图分类号】R453B1008—6315(2015)10—0425—02新生儿湿肺(transienttachypneaofthenewborn,TTN)又称新生儿暂吋性呼吸困难，发生率在0.3%〜12•0%，其中经阴道分娩为0.33.0%，剖宫产为0.9%-12.0°%[1].主要临床表现为生后立即或数小吋后呼吸急促、鼻翼扇动、呻吟、紫绀，伴

8、或不伴血y氧饱和度的降低等，胸部X线见肺泡及间质积液、肺气肿、肺叶间隙、胸腔积液