Gortner L, Tutdibi E
Universitätsklinikum des Saarlandes, Klinik für Allgemeine Pädiatrie und Neonatologie, Homburg/Saar.
Z Geburtshilfe Neonatol. 2011 Aug;215(4):145-51. doi: 10.1055/s-0031-1285835. Epub 2011 Aug 23.
Respiratory disorders remain a major problem in postnatal adaptation. In term neonates, an increased incidence of the risk for transient tachypnoea of the neonate has been observed during the past decade, most likely secondary to an increased usage of primary Caesarean section. The disorder is mainly caused by a delayed resorption of foetal lung fluid. Further disorders in term neonates include meconium aspiration syndrome and congenital diaphragmatic hernia leading to impaired gas exchange and pulmonary hypertension. In preterm neonates, respiratory distress syndrome is the main disorder leading to severe acute and long-term impaired gas exchange. Prenatal administration of glucocorticoids and postnatal surfactant therapy remains an established principle in perinatal care for very preterm neonates. The most relevant long-term sequelae, bronchopulmonary dysplasia, is currently being observed in about 15% of preterms with less than 32 weeks of gestation and is associated with severe pulmonary and extrapulmonary consequences. Due to the overall improvement in perinatal care, respiratory disorders still remain a major problem in pulmonary adaptation. However, mortality secondary to neonatal lung failure has been decreased substantially by the improvements in the whole field of perinatal medicine.
呼吸紊乱仍是出生后适应过程中的一个主要问题。在足月儿中，过去十年间观察到新生儿短暂性呼吸急促的风险发生率增加，这很可能继发于剖宫产使用率的上升。该病症主要由胎儿肺液吸收延迟所致。足月儿的其他病症包括胎粪吸入综合征和先天性膈疝，会导致气体交换受损和肺动脉高压。在早产儿中，呼吸窘迫综合征是导致严重急性和长期气体交换受损的主要病症。产前给予糖皮质激素和产后使用表面活性剂治疗仍是极早产儿围产期护理的既定原则。最相关的长期后遗症支气管肺发育不良，目前在妊娠不足32周的早产儿中约有15%会出现，并伴有严重的肺部和肺外后果。尽管围产期护理总体有所改善，但呼吸紊乱在肺部适应方面仍然是一个主要问题。然而，由于围产医学整个领域的进步，新生儿肺衰竭导致的死亡率已大幅下降。
