2010年江苏淮安基于出生人口新生儿呼吸衰竭流行病学调查

A population-based epidemiological survey of neonatal respiratory failure in Huai'an City of Jiangsu Province, in 2010

摘要:

目的 调查江苏省淮安市2010 年出生人口的新生儿呼吸衰竭(NRF)发生率、主要临床特点及治疗和转归情况.方法 采用描述性流行病学调查方法,对2010 年江苏省淮安市各医院所有NRF 患儿的信息进行前瞻性收集.结果 2010 年淮安市活产婴儿数共60 986 人,发生NRF 556 例,发生率为0.91%.NRF 患儿平均出生体重为2 433±789 g,低出生体重儿占53.8%.早产儿占64.1%.引起呼吸衰竭的原发病依次为呼吸窘迫综合征、肺炎、窒息、败血症、肺出血等.23.7% NRF 患儿伴有某种出生缺陷.14.0% 的NRF 患儿接受肺泡表面活性物质(PS)治疗,给予PS 首剂的中位时间为5 h(范围0~51 h).67.9% 使用nCPAP 治疗,33.3% 接受常频机械通气治疗,13.7% 接受高频通气治疗.患儿治愈、好转率为73.9%(411/556),病死率为22.5%(125/556).平均住院费用为9 270(范围196~38 182)元.结论 NRF 是江苏淮安地区一个高发病率、高病死率以及高住院费用的严峻问题,应加强围生期的保健以及出生后呼吸救治新技术以及新模式的应用,以降低NRF 的发生率及病死率.

Abstract:

Objective To investigate the prevalence, clinical characteristics, treatment, and prognosis of neonatal respiratory failure (NRF) in Huai'an, Jiangsu Province, China, in 2010. Methods The clinical data of all NRF cases inthe hospitals of Huai'an in 2010 were prospectively collected and analyzed using descriptive epidemiological methods.Results Among 60 986 live births in Huai'an in 2010, there were 556 (0.91%) cases of NRF. The average birth weightof newborns with NRF was 2 433±789 g, with 53.8% determined as low birth weight and 64.1% as preterm. The majorcauses of NRF were respiratory distress syndrome, pneumonia, asphyxia, sepsis, and pulmonary hemorrhage. Among thenewborns with NRF, 23.7% were accompanied by certain birth defects. Fourteen percent of newborns with NRF received pulmonary surfactant (PS) therapy, and the median time of the first dose of PS was 5 hours (range:0-51 hours). Nasalcontinuous positive airway pressure treatment, conventional mechanical ventilation, and high-frequency ventilation wereused in 67.9%, 33.3%, and 13.7% of patients, respectively. The cure and improvement rate of NRF patients was 73.9%(411/556), and the mortality rate was 22.5% (125/556). The average hospitalization expenses were 9 270 (range:196-38182) Yuan. Conclusions High morbidity, high mortality and high medical costs make NRF a serious challenge in Huai'an. It is essential to improve the quality of perinatal care and develop new techniques and new models in neonatal respiratory therapy in order to reduce the morbidity and mortality of NRF.