不同分娩方式对晚期早产儿呼吸系统疾病的影响研究  

Study on the effects of different delivery modes on respiratory system diseases in late preterm infants

作　　者：王洪波[1] 张秋丽[1] 周建生[1] 蔡娟[1] 贺瑞荣[1] 王燕玲[1] 

机构地区：[1]石嘴山市第一人民医院儿科,宁夏石嘴山753200

出　　处：《中国妇幼保健》2017年第12期2653-2657,共5页Maternal and Child Health Care of China

摘　　要：目的探讨不同分娩方式对晚期早产儿呼吸系统疾病发生及预后的影响。方法以2010年1月-2015年12月在石嘴山市第一人民医院产科出生的晚期早产儿作为研究对象,将符合入选条件的早产儿按照出生胎龄分成34、35和36周3组,然后根据分娩方式再次进行分类,将选择性剖宫产(ECS)的252例早产儿作为ECS组,358例阴道分娩的早产儿作为阴道分娩组,124例急诊剖宫产的早产儿作为急诊剖宫产组。分析分娩方式与不同胎龄的晚期早产儿呼吸系统并发症发生及预后的相关性。结果 ECS组早产儿发生呼吸系统疾病105例,发病率41.7%,急诊剖宫产组早产儿发生呼吸系统疾病56例,发病率45.2%,与ECS组发病率比较,差异无统计学意义(P>0.05);358例阴道分娩的早产生儿发生呼吸系统疾病72例,发病率20.1%,ECS组比阴道分娩组具有更高的呼吸系统疾病发病率,差异有统计学意义(P<0.05)。34和35周组的晚期早产儿,ECS者比阴道分娩者呼吸窘迫综合征(RDS)发病率更高,差异有统计学意义(P<0.05);34、35及36周组的晚期早产儿RDS和湿肺(TTN)发病率比较均是ECS者比阴道分娩者更高,差异有统计学意义(P<0.05)。34、35及36周组的晚期早产儿ECS者与阴道分娩者相比,住院时间更长、新生儿重症监护室(NICU)入住率和持续正压通气(CPAP)使用率更高,差异有统计学意义(P<0.05)。结论 ECS和急诊剖宫产晚期早产儿呼吸系统疾病发病风险相当;相对于阴道分娩,ECS会增加晚期早产儿呼吸系统疾病发生率及预后不良,临床需尽量控制ECS率。Objective To explore the effects of different delivery modes on respiratory system diseases and prognosis in late preterm infants. Methods The late preterm infants born in Department of Obstetrics in the hospital from January 2010 to December 2015 were selected,then they were divided into 34-week group,35-week group,and 36-week group according to fetal age at birth; at the same time,all the late preterm infants were divided into elective cesarean section group（ 252 late preterm infants,ECS group）,vaginal delivery group（ 358 late preterm infants）,and emergency cesarean section group（ 124 late preterm infants） according to delivery modes. The correlations between incidence rates of respiratory complications and prognosis in different groups were analyzed. Results The incidence rates of respiratory diseases in ECS group and emergency caesarean section group were 41. 7%（ 105 infants） and 45. 2%（ 56 infants）,respectively,there was no statistically significant difference between the two groups（ P〉0. 05）; the incidence rate of respiratory diseases in vaginal delivery group was 20. 1%（ 72 infants）,compared with ECS group,there was statistically significant difference（ P〈0. 05）. Among the late preterm infants in 34-week group and 35-week group,the incidence rate of respiratory distress syndrome（ RDS） in ECS group was statistically significantly higher than that in vaginal delivery group（ P〈0. 05）. Among the late preterm infants in 34-week group,35-week group,and36-week group,the incidence rates of RDS and transient tachypnea（ TTN） in ECS group were statistically significantly higher than those in vaginal delivery group（ P〈0. 05）. Compared with vaginal delivery group,the late preterm infants in ECS group had longer hospitalization time,higher admission rate of NICU,and higher utilization rate of continuous positive airway pressure（ CPAP）,there were statistically significant differences（ P〈0. 05）. Conclusion The risks of respiratory diseases are equivalent in

关 键 词：分娩方式 晚期早产儿 呼吸系统疾病 

分 类 号：R725[医药卫生—儿科]