选择性剖宫产足月儿呼吸窘迫综合征患儿的回顾性分析  

Respective analysis of elective cesarean section for term infants with respiratory distress syndrome

作　　者：苗翠华[1] 

机构地区：[1]邳州市人民医院小儿内科,江苏邳州221300

出　　处：《中国民康医学》2015年第22期3-5,34,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:探讨选择性剖宫产对足月儿呼吸窘迫综合征(RDS)患儿的影响。方法:回顾性分析新生儿重症监护室(NICU)收治的96例RDS住院足月患儿临床资料,根据分娩方式分为选择性剖宫产组(68例,占70.83%)和自然分娩组(28例,占29.17%);另外,根据新生儿有无并发症分为并发症组(63例,占65.63%)和无并发症组(33例,占34.37%)。比较两组患儿临床特点。结果:选择性剖宫产组患儿与自然分娩组足月儿在出生体重、胎龄、窒息史差异无统计学意义(P>0.05);但在入院年龄、肺表面活性剂(PS)应用及开始上机时间差异有统计学意义(P<0.05)。68例选择性剖宫产产妇,其中37周和38周共61例(占89.71%);39周以上7例(占10.29%)。有并发症患儿在入院年龄、窒息史及开始上机时间方面与无并发症患儿差异有统计学意义(P<0.05)。入院年龄及开始上机时间是患儿发生并发症的危险因素(P<0.05),尤其是开始上机时间在12 h以上是患儿发生并发症的主要危险因素。结论:分娩未发动的选择性剖宫产与足月儿发生RDS密切相关,随着胎龄增加,RDS发病率大大降低。因此,选择性剖宫产的时机恰当对降低RDS有重要意义,且早期诊断RDS、早期干预可显著降低足月儿RDS并发症的发生率。Objective: To investigate effects of selective cesarean section on term infants with respiratory distress syndrome ( RDS) . Methods:The clinical data of 96 term infants with RDS in neonatal intensive care unit ( NICU) were retrospective analyzed. They were divided into elective cesarean section group (68 cases, 70. 83%) and natural delivery group (28 cases, 29. 17%) depen-ding on the modes of delivery. In addition, these infants were divided into complication group (63 cases, 65. 63%) and non-compli-cation group (33 cases, 34. 37%) based on the complications. The clinical effects of the two groups were compared. Results:There were no statistical differences in birth weight, gestational age, asphyxia between elective cesarean section group and natural delivery group (P>0.05); however, there were statistical differences in the age of admission, PS application and machine start time (P<0. 05). In the elective cesarean section group, 61 cases (89. 71%) had the gestational age of 37 weeks and 38 weeks, and 7 cases (10. 29%) had the gestational age of more than 39 weeks. There were statistical differences in the age of admission, asphyxia and ma-chine start time between complication group and non-complication group (P<0. 05). The age of admission and machine start time were the risk factors for the children's complications (P<0. 05), especially, the machine start time over 12h is the main risk factors. Con-clusions:The elective cesarean section of term infants is closely related to the occurrence of RDS. As the gestational age increases, the incidence of RDS is significantly reduced. Therefore, the proper timing of elective cesarean section is important in reducing RDS, and early diagnosis RDS and early intervention can significantly reduce the incidence of term infants RDS complications.

关 键 词：足月儿 选择行剖宫产 自然分娩 呼吸窘迫综合征 

分 类 号：R719.8[医药卫生—妇产科学]