中国13家医院住院分娩早产儿呼吸窘迫综合征前瞻性调查分析  

Respiratory distress syndrome in inborn preterm neonates:a prospective study from 13 hospitals in China

作　　者：徐凤丹[1,2] 段顺艳 孔祥永[2] 封志纯[2] 张珊[2] 吴鸿雁[2] 吕红艳[3] 杨李红[3] 吴素静[3] 巨容 汪瑾 彭立 李占魁 赵小林 曾淑娟[6] 丘惠娴[6] 温伟溪 武辉[7] 李莹[7] 李楠[7] 贾文峥[8] 张雪峰[8] 郭果[8] 刘卫鹏[9] 王凤[9] 李改梅[9] 刘芳[10] 李薇[10] 赵晓英[10] 程红斌[11] 许云波[11] 陈文超[11] 尹欢[11] 丁艳洁[12] 王晓亮[12] 单瑞艳[12] 陈铁强[13] 许平[14] 韩梅盈 杨春燕[14] XU Feng-dan DUAN Shun-yan KONG Xiang-yong FENG Zhi-chun ZHANG Shan WU Hong-yan Lü Hong-yan YANG Li-hong WU su-jing JU rong WANG jin PENG Li LI Zhan-kui ZHAO Xiao-lin ZENG Shu-juan QIU Hui-xian WEN Wei-xi WU Hui LI Ying LI Lan JIA Wen-zheng ZHANG Xue-feng GUO Guo LIU Wei-peng WANG Feng LI Gai-mei LIU Fang LI Wei ZHAO Xiao-ying CHENG Hong-bin XU Yun-bo CHEN Wen-chao YIN Huan DING Yan-jie WANG Xiao-liang SHAN Rui-yan CHEN Tie-qiang XU Ping HAN Mei-ying YANG Chun-yan(Multicenter collaborative team for the study of RDS in preterm neonates in urban of China,Department of Pediatrics, Guang Dong Medical University,Department of Pediatrics, Ba Yi Children’s Hospital Affiliated to Clinical Medical College in Beijing Military General Hospital of Southern Medical University,Department of Pediatrics,Handan maternity and child care centers,Neonatal Intensive Care Unit, Chengdu Women ＆ Children’s Central Hospital,Neonatal Intensive Care Unit,Shanxi Maternal and Child Care Service Centre,Neonatal Intensive Care Unit, Longgang District Central Hospital of Shenzhen,Department of Pediatrics, First Hospital of Jilin University,Department of Pediatrics, 302 Military Hospital of China,Department of Pediatrics, Navy General Hospital,Department of Pediatrics, Bethene International Peace Hospital,Department of Neonatology, Huangshi Maternal and Child Health Hospital,Department of Pediatrics,Yantai Yuhuangding Hospital,Department of Pediatrics, Changsha Hospital for Maternal and Child Health Care,Department of Pediatrics, Liaocheng People’s Hospital)

机构地区：[1]广东医科大学,广东东莞523808 [2]北京军区总医院附属八一儿童医院新生儿科,北京100700 [3]邯郸市妇幼保健院新生儿科,河北邯郸056001 [4]成都市妇女儿童中心医院新生儿科,成都610091 [5]陕西省妇幼保健院新生儿科,西安710061 [6]深圳市龙岗中心医院新生儿科,广东深圳518116 [7]吉林大学第一医院新生儿科,长春130021 [8]中国人民解放军第三〇二医院新生儿科,北京100039 [9]中国人民解放军海军总医院新生儿科,北京100048 [10]白求恩国际和平医院新生儿科,石家庄050082 [11]黄石市妇幼保健院新生儿科,湖北黄石435003 [12]烟台毓璜顶医院新生儿科,山东烟台264000 [13]长沙市妇幼保健院新生儿科,长沙410007 [14]聊城市人民医院新生儿科,山东聊城252000

出　　处：《发育医学电子杂志》2016年第2期106-118,共13页Journal of Developmental Medicine (Electronic Version)

摘　　要：目的了解国内住院分娩早产儿呼吸窘迫综合征（respiratory distress syndrome,RDS）的发生率、病死率、并发症特点、发生高危因素、产前激素应用对早产儿RDS的发生率及预后的影响。方法收集国内13家医院2014年1月1日至12月31日住院分娩的24周≤胎龄〈37周的全部早产儿共7684例。前瞻性分析RDS发生率、病死率、并发症、发生高危因素及产前应用地塞米松的效果。结果活产出生新生儿共75 360例,其中早产儿7 684例（其中入院早产儿6604例,非入院1080例）,早产儿发生率为10.2%。其中极早产儿957例,占12.5%;超早产儿92例,占1.2%。发生RDS 1 177例,发生率为15.3%。24周≤胎龄〈25周、25周≤胎龄〈26周、26周≤胎龄〈27周、27周≤胎龄〈28周、28周≤胎龄〈29周、29周≤胎龄〈30周、30周≤胎龄〈31周、31周≤胎龄〈32周、32周≤胎龄〈33周、33周≤胎龄〈34周、34周≤胎龄〈35周、35周≤胎龄〈36周、36周≤胎龄〈37周早产儿RDS发生率分别为100.0%、90.0%、85.0%、85.1%、81.0%、74.3%、55.4%、47.1%、33.1%、17.9%、9.6%、5.0%、1.9%。出生体重〈500 g、500~749 g、750~999 g、1 000~1 499 g、1 500~2 499 g、2 500~4 000 g、〉4 000 g早产儿RDS的发生率分别为100.0%、100.0%、79.2%、55.8%、15.0%、3.6%、9.5%。RDS早产儿病死率为10.5%,其中胎龄24周≤胎龄〈25周、25周≤胎龄〈26周、26周≤胎龄〈27周、27周≤胎龄〈28周、28周≤胎龄〈29周、29周≤胎龄〈30周、30周≤胎龄〈31周、31周≤胎龄〈32周、32周≤胎龄〈33周、33周≤胎龄〈34周、34周≤胎龄〈35周、35周≤胎龄〈36周、36周≤胎龄〈37周早产儿RDS病死率,分别为100%、70.0%、23.5%、20.0%、16.2%、10.3%、8.1%、9.6%、8.9%、6.0%、5.5%、8.8%、4.5%。RDS患儿颅内出血（ICH）、早产儿视网膜病（ROP）、支气管肺发育不良（BPD）、坏死性小肠结肠炎（NEC）、动脉导管未闭（PDA）、肺出血及败血症的发�Objective To investigate the morbidity, mortality, characteristics of the complications, high risk factors and the effects of antenatal corticosteroids on the morbidity and prognosis of respiratory distress syndrome in inborn preterm neonates in China. Method Data were collected from January 1, 2014 to December 31, 2014 for premature with gestational age 37 weeks born in Obstetric. The morbidity, mortality, characteristics of the complications, high risk factors, effect of antenatal corticosteroids were analysis retrospectively. Results From a total of 75 360 live birth newborns, there were 7 684 cases（10.2%） of preterm neonates, of which 957 cases（12.5%） were extreme prematurity and 92 cases（1.2%） were severe/moderate prematurity. Of these preterm neonates, a total of 1 177 were classified as RDS（15.3%）. The morbidity of RDS in neonates with 24≤GA25、25≤GA26、26≤GA27、27≤GA28、28≤GA29、29≤GA30、30≤GA31、31≤GA32、32≤GA33、33≤GA34、34≤GA35、35≤GA36 and36≤GA37 weeks were 100.0%、90.0%、85.0%、85.1%、81.0%、74.3%、55.4%、47.1%、33.1%、17.9%、9.6%、5.0% and 1.9%, respectively. The morbidity of RDS in preterm neonates with BW500,500-749, 750-999, 1 000-1 499, 1 500-2 499, 2 500-4 000 and more than 4 000 grams were 100.0%,100.0%,79.2%, 55.8%, 15.0%, 3.6% and 9.5%, respectively. The mortality of preterm neonates with RDS was 10.5%. The mortality of RDS in neonates with 24≤GA25、25≤GA26、26≤GA27、27≤GA28、28≤GA29、29≤GA30、30≤GA31、31≤GA32、32≤GA33、33≤GA34、34≤GA35、35≤GA36 and 36≤GA37 weeks were 100.0%,70.0%, 23.5%, 20.0%, 16.2%, 10.3%, 8.1%, 9.6%, 8.9%, 6.0%, 5.5%, 8.8% and 4.5%, respectively. The incidence of ICH, ROP, BPD, NEC, PDA, pulmonary hemorrhage and sepsis in preterm neonates with RDS were higher than those without RDS. Logistic regressions showed that male, GA33 weeks, BW2 500 grams, body length 40 cm, neonatal asphyxia production time≥2 times, and placenta praevia were risk factors for RDS. Multiple pregn

关 键 词：早产儿 呼吸窘迫综合征 产前激素 前瞻性调查分析 

分 类 号：R722.6[医药卫生—儿科]