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通过避免围产期窒息减少早产儿脑出血和呼吸窘迫综合征

[Reduction of cerebral hemorrhage and respiratory distress syndrome in premature infants by avoiding perinatal asphyxia].

作者信息

Segerer H, Landendörfer W, Deeg K H, Richter K

机构信息

Universitäts-Kinderklinik, Erlangen.

出版信息

Monatsschr Kinderheilkd. 1988 Apr;136(4):176-80.

PMID:3386647
Abstract

Intra- and periventricular haemorrhage (IVH/PVH) and, under certain conditions, the respiratory distress syndrome (RDS) seem to be typical sequelae of perinatal asphyxia in preterm born infants. Therefore, an association of IVH/PVH and RDS can be expected. We have retrospectively analyzed the data of 118 premature infants born between 1982 and 1986, weighing between 750 and 1499 g. 11 of these had experienced a severe IVH/PVH and a severe RDS at the same time, whereas 75 infants did not develop either of those. (2 of the 118 showed a severe IVH/PVH without evidence of severe RDS whereas 29 developed severe RDS without signs of serious IVH/PVH. 1 could not be evaluated due to missing data). This association of severe intracerebral haemorrhage and severe respiratory distress syndrome was statistically significant (p less than 0.005). The number of severe IVH/PVH has decreased during 1984-1986 in comparison to 1982/83 (4/76 vs. 9/42; p less than 0.05); the incidence of severe RDS has slightly declined. Comparing the perinatal conditions we found that the infants of the years 1984-1986 were more rarely delivered after an interval exceeding 24 h after premature rupture of the membranes (p less than 0.05), were more often delivered by caesarean section (p less than 0.005), and were nearly always primarily cared for by an experienced paediatrician (p less than 0.01). There were no significant differences between these two groups as far as dexamethasone-prophylaxis, mean birth weight, percentage of small-for-gestational-age infants and mean Apgar scores were concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

脑室内及脑室周围出血(IVH/PVH),以及在某些情况下的呼吸窘迫综合征(RDS)似乎是早产婴儿围产期窒息的典型后遗症。因此,可以预期IVH/PVH与RDS之间存在关联。我们回顾性分析了1982年至1986年间出生的118例早产儿的数据,体重在750至1499克之间。其中11例同时经历了严重的IVH/PVH和严重的RDS,而75例婴儿未发生这两种情况中的任何一种。(118例中有2例出现严重的IVH/PVH但无严重RDS的证据,而29例出现严重RDS但无严重IVH/PVH的迹象。1例因数据缺失无法评估)。严重脑出血与严重呼吸窘迫综合征之间的这种关联具有统计学意义(p小于0.005)。与1982/83年相比,1984 - 1986年间严重IVH/PVH的数量有所减少(4/76对9/42;p小于0.05);严重RDS的发生率略有下降。比较围产期情况,我们发现1984 - 1986年的婴儿在胎膜早破超过24小时后分娩的情况较少(p小于0.05),剖宫产分娩的情况较多(p小于0.005),并且几乎总是由经验丰富的儿科医生进行初步护理(p小于0.01)。就地塞米松预防、平均出生体重、小于胎龄儿百分比和平均阿氏评分而言,这两组之间没有显著差异。(摘要截断于250字)

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