1108例新生儿呼吸衰竭的临床流行病学特征

Clinical epidemiological characteristics of neonatal respiratory failure: an analysis of 1 108 neonates

摘要:

目的 对1 108 例新生儿呼吸衰竭病例的临床流行病学特征进行分析,为提高临床治疗水平和开展多中心临床研究提供参考。方法 采用统一调查表收集1 108 例呼吸衰竭新生儿的临床资料,对原发疾病、临床治疗方法、治疗结局、病死率等流行病学指标进行统计学分析。结果 1 108 例患儿中位胎龄为37+1 周,中位出生体重为2 600 g,入NICU 中位日龄为0.71 d(17 h),男/ 女比例为3.1:1。主要原发疾病为呼吸窘迫综合征(30.51%)、肺部感染/ 败血症(23.55%)和湿肺(13.18%)。治疗中采用经鼻持续气道正压通气(nCPAP)占48.64%,高频振荡通气占12.81%、使用肺表面活性物质占13.45%、NO 吸入治疗占8.66%,病死率达24.19%。结论 呼吸窘迫综合征为新生儿呼吸衰竭的主要原发疾病,使用肺表面活性物质、nCPAP、高频振荡通气、NO 吸入治疗已经成为新生儿呼吸衰竭的主要救治手段,但新生儿呼吸衰竭的病死率仍然较高。

Abstract:

Objective To investigate the clinical epidemiological characteristics of neonatal respiratory failure in 1 108 neonates, and to provide a reference for improvement in clinical treatment and multicenter clinical studies. Methods The clinical data of 1 108 neonates with respiratory failure were collected with questionnaires, and statistical analysis was performed for the epidemiological indices including primary diseases, clinical therapeutic methods, treatment outcome, and fatality. Results In all the neonates with respiratory failure, the median gestational age was 37 weeks +1 day, the median birth weight was 2 600 g, the median age in days on admission to neonatal intensive care unit was 0.71 days (17 hours), and the boy/girl ratio was 3.1:1. The major primary diseases were respiratory distress syndrome (30.51%), pulmonary infection/sepsis (23.55%), and wet lung (13.18%). Of all the neonates, 48.64% received nasal continuous positive airway pressure (nCPAP), 12.81% received high-frequency oscillatory ventilation, 13.45% received pulmonary surfactant, and 8.66% received nitric oxide inhalation therapy. The fatality was 24.19%. Conclusions The major primary disease for neonatal respiratory failure is respiratory distress syndrome. Pulmonary surfactant, nCPAP, high-frequency oscillatory ventilation, and nitric oxide inhalation therapy are major therapeutic methods for neonatal respiratory failure, but neonatal respiratory failure still has a high fatality.