读懂新生儿急性呼吸窘迫综合征的关键词:叠加  

Superimposition:a key word in neonatal acute respiratory distress syndrome

作　　者：封志纯 赵喆[1] 史源[2] Feng Zhichun;Zhao Zhe;Shi Yuan(Department of Neonatology,Bayi Children's Hospital,Seventh Medical Center of Chinese PLA General Hospital,Faculty of Pediatrics Clinical Medicine,Chinese PLA General Hospital,Beijing 100710,China;Department of Neonatology,Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Chongqing 400014,China)

机构地区：[1]解放军总医院第七医学中心八一儿童医院新生儿科,解放军总医院儿科临床医学部,北京100710 [2]重庆医科大学附属儿童医院新生儿科,国家儿童健康与疾病临床医学研究中心,400014

出　　处：《中华围产医学杂志》2021年第4期273-277,共5页Chinese Journal of Perinatal Medicine

基　　金：国家自然科学基金(30973210)。

摘　　要：欧美学者于2017年推出了新生儿急性呼吸窘迫综合征(neonatal acute respiratory distress syndrome,nARDS)的蒙特勒标准,国内学者近十多年来关于nARDS特殊性和重要性的强烈主张获得支持。新生儿特发性呼吸窘迫综合征的主因是原发性肺表面活性物质系统功能不足,病理和临床表现一般都呈现典型呼吸窘迫综合征的单束集合;而nARDS的病因在主因外尚叠加有原发病因,病理和临床表现则是在呼吸窘迫综合征外叠加有原发病的多束集合。可见,"叠加"贯穿nARDS病因学、病理学、诊断学、治疗学的全过程。因此,读懂"叠加",对准确把握和推动该领域的临床实践具有积极作用。The Montreux definition established in 2017 made it clear that the neonates can not be excluded from the diagnosis of acute respiratory distress syndrome(ARDS),which supported the urge of emphasizing the specificity and importance of neonatal ARDS(nARDS)in the past ten years in China.Neonatal idiopathic respiratory distress syndrome is caused primarily by insufficient pulmonary surfactant system,which pathologically and clinically presented as typical respiratory distress syndrome.While the causes of nARDS often coexisted with underlying conditions,and its pathological and clinical features are a superposition of both respiratory distress syndrome and underlying conditions.Therefore,superimposition is the key to understanding the etiology,pathology,diagnosis,and treatment of nARDS,which is crucial for optimizing the clinical practice of nARDS.

关 键 词：呼吸窘迫综合征 新生儿 急性病 诊断 鉴别 

分 类 号：R722.1[医药卫生—儿科]