北京地区晚期早产儿出生早期呼吸系统疾病的多中心现状调查  

A multicenter survey of short-term respiratory morbidity in late-preterm infants in Beijing

作　　者：韩形妍 童笑梅[1] 张欣[2] 刘捷[3] 杨立 刘慧 闫菊[6] 宋志芳 梅亚波 徐小静 米荣[10] 秦选光[11] 刘玉环 齐宇洁 张巍[14] 曾慧慧[14] 崔红[15] 龙卉 郭果 陈旭琳 杨召意 孙芳[20] 王长燕[21] 李正红[21] Han Tongyan;Tong Xiaomei;Zhang Xin;Liu Jie;Yang Li;Liu Hui;Yan Ju;Song Zhifang;Mei Yabo;Xu Xiaojing;Mi Rong;Qin Xuanguang;Liu Yuhuan;Qi Yujie;Zhang Wei;Zeng Huihui;Cui Hong;Long Hui;Guo Guo;Chen Xulin;Yang Zhaoyi;Sun Fang;Wang Changyan;Li Zhenghong(Department of Pediatrics,Peking University Third Hospital,Beijing 100191,China;Department of Pediatrics,Peking University First Hospital,Beijing 100034,China;Department of Pediatrics,Peking University People′s Hospital,Beijing 100044,China;Department of Pediatrics,Tongzhou Maternal&Child Health Hospital of Beijing,Beijing 101101,China;Department of Pediatrics,People′s Hospital of Beijing Daxing District,Beijing 102600,China;Department of Neonatology,Beijing Hospital,Beijing 100730,China;Department of Pediatrics,Yanqing Hospital,Beijing 102100,China;Department of Pediatrics,General Hospital of the Chinese People′s Liberation Army Seventh Medical Center,Beijing 100710,China;Department of Pediatrics,the First Hospital of Tsinghua University,Beijing 100016,China;Department of Pediatrics,Children′s Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China;Department of Pe-diatrics,Capital Medical University Chaoyang Hospital,Beijing 100043,China;Department of Pediatrics,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Neonatal Center,Beijing Children′s Hospital,Capital Me-dical University,Beijing 100045,China;Department of Pediatrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;Department of Pediatrics,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;Department of Pediatrics,General Hospital of the Chinese People′s Liberation Army First Medical Center,Beijing 100853,China;Department of Pediatrics,General Hospital of the Chinese People′s Liberation Army Fifth Medical Center,Beijing 100039,China;Department of Pediatrics,General Hospital of the Chinese People′s Liberation Army Third Medical Center,Beijing 100101,China;Department of Pediatrics,General

机构地区：[1]北京大学第三医院儿科,100191 [2]北京大学第一医院儿科,100034 [3]北京大学人民医院儿科,100044 [4]北京市通州区妇幼保健院儿科,101101 [5]北京市大兴区人民医院儿科,102600 [6]北京医院新生儿科,100730 [7]北京市延庆区医院儿科,102100 [8]中国人民解放军总医院第七医学中心儿科,北京100710 [9]清华大学第一附属医院儿科,北京100016 [10]首都儿科研究所附属儿童医院儿科,北京100020 [11]首都医科大学附属北京朝阳医院儿科,北京100033 [12]首都医科大学附属北京地坛医院儿科,北京100015 [13]首都医科大学附属北京儿童医院新生儿中心,北京100045 [14]首都医科大学附属北京妇产医院儿科,北京100026 [15]首都医科大学附属北京友谊医院儿科,北京100050 [16]中国人民解放军总医院第一医学中心儿科,北京100853 [17]中国人民解放军总医院第五医学中心儿科,北京100039 [18]中国人民解放军总医院第三医学中心儿科,北京100101 [19]中国人民解放军总医院第六医学中心儿科,北京100048 [20]中日友好医院儿科,北京100029 [21]中国医学科学院北京协和医学院北京协和医院儿科,北京100730

出　　处：《中华实用儿科临床杂志》2020年第16期1230-1234,共5页Chinese Journal of Applied Clinical Pediatrics

基　　金：北京市卫生和计划委员会科技项目(京卫科2016001);中国医学科学院医学与健康科技创新工程项目(2016-12M-1-008);北京大学第三医院临床重点项目孵育B类(BYSY2018038)。

摘　　要：目的调查晚期早产儿呼吸系统疾病的发生情况,分析发生呼吸系统合并症的晚期早产儿的危险因素。方法收集晚期早产儿的临床数据,以2015年10月至2016年4月来自北京地区21家医院的晚期早产儿为研究对象,其中出生后短期发生呼吸系统疾病患儿为呼吸系统疾病组,无呼吸系统疾病患儿为对照组,比较2组患儿临床资料。结果共入组959例晚期早产儿,其中男530例,女429例。959例中237例发生呼吸系统疾病,发病率为24.7%,以感染性肺炎为最多[81例(8.4%)],其次为新生儿湿肺[65例(6.8%)],第3位为羊水吸入[51例(5.3%)],新生儿呼吸窘迫综合征居第4位[24例(2.5%)]。患儿均痊愈出院。呼吸系统疾病组237例,对照组722例,2组性别、母亲年龄等比较差异均无统计学意义(均P>0.05)。呼吸系统疾病组患儿剖宫产娩出者更多(73.4%比59.7%,χ^2=14.43,P<0.001),1分钟Apgar评分较低[(9.41±1.66)分比(9.83±0.53)分,t=5.40,P<0.001],差异均有统计学意义。呼吸系统疾病组患儿母亲有合并症者较多(66.7%比58.6%,χ^2=4.877,P=0.027),各种合并症比较差异无统计学意义(P>0.05),但呼吸系统疾病组患儿母亲以妊高征及先兆子痫较多(27.8%比22.6%,χ^2=2.728,P=0.099)。2组患儿出生胎龄、体质量、身长比较差异均无统计学意义(均P>0.05),呼吸系统疾病组患儿小于胎龄儿和大于胎龄儿较多(18.8%比14.1%,6.3%比2.4%,χ^2=8.960,P=0.011)。呼吸系统疾病组患儿,因为需要住院治疗,住院天数显著长于对照组患儿[(9.00±4.42)d比(6.82±4.19)d,t=6.676,P<0.001]。结论晚期早产儿中约1/4发生呼吸系统疾病,母亲孕期有妊高征和先兆子痫、剖宫产娩出患儿需密切监测,非适于胎龄儿更易于患呼吸系统疾病,应给予适宜的呼吸支持治疗,以利于顺利渡过转换期。Objective To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group(237 cases)and the control group(722 cases)according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results Among the 959 late-preterm babies,530 were male and 429 were female.Two hundred and thirty-seven cases(24.7%)developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases(81 cases,8.4%),followed by transient tachypnea(65 cases,6.8%),amniotic fluid aspiration(51 cases,5.3%),and respiratory distress syndrome(24 cases,2.5%)successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups(all P>0.05).Compared with the control group,more late-preterm infants were delivered by cesarean section(73.4%vs.59.7%,χ2=14.43,P<0.001)and the 1-minute Apgar score was lower[(9.41±1.66)scores vs.(9.83±0.53)scores,t=5.40,P<0.001]in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group(66.7%vs.58.6%,χ2=4.877,P=0.027),but no difference in various complications between 2 groups was observed(P>0.05).In the respiratory morbidity group,the most frequent complications were maternal hypertension and preeclampsia(27.8%vs.22.6%,χ2=2.728,P=0.099).There were no differences between 2 groups in gestational age,birth weight and birth length(all P>0.05).There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group(18.8%vs.14.1%,6.3%vs.2.4%,χ2=8.960,P=0.011).The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the

关 键 词：呼吸系统疾病 危险因素 晚期早产儿 

分 类 号：R722.6[医药卫生—儿科]