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足月和近足月新生儿表面活性物质缺乏性呼吸窘迫综合征的临床特征、诊断和治疗结局:一项回顾性观察研究。

Clinical characteristics, diagnosis, and management outcome of surfactant deficiency respiratory distress syndrome in term and near-term neonates. A retrospective observational study.

机构信息

Hamad Medical corporation WWRC.

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出版信息

Acta Biomed. 2022 Dec 16;93(6):e2022337. doi: 10.23750/abm.v93i6.13794.

Abstract

AIM

This study aims to describe the clinical characteristics of SRDS in term and late preterm neonates.

METHODS

This is an observation retrospective chart review of full-term and late preterm neonates born older than 35 to 41 weeks gestation age diagnosed with SRDS. The diagnosis was based on clinical & radiological manifestations of SRDS.

RESULTS

1547 neonates were admitted during this period to NICU with a diagnosis of increased work of breathing for further management. 117 cases of term and near-term neonates (mean GA = 36.8 wks) had a confirmed diagnosis of Surfactant deficiency SRDS. Who compared 60 preterm neonates with SRDS less than 35 weeks gestation (mean GA 27.5 wks) as a control. The mean birth weight was 2.8 kg vs 1.1 kg in the preterm group. SRDS occurs more among the male gender (58%), with CS in 78.6 % of all diagnosed cases. No apparent cause was found in 28.2 %, while 37.6% of all cases were born to mothers with diabetes mellitus, and 27% were born to mothers with either GBs infection, maternal chorioamnionitis, or prolonged rupture of the membrane.

CONCLUSION

SRDS is not uncommon among full-term and near-term neonates (10/1000 live birth). By far, the most common associated risk factors are maternal diabetes mellitus and cesarean section. It affects males more than females. Most cases will run a mild-to-moderate course that responds to non-invasive ventilation.

摘要

目的

本研究旨在描述足月和晚期早产儿呼吸窘迫综合征(SRDS)的临床特征。

方法

这是一项对胎龄 35 周至 41 周以上、诊断为 SRDS 的足月和晚期早产儿的观察性回顾性图表研究。诊断基于 SRDS 的临床和影像学表现。

结果

在此期间,有 1547 名新生儿因呼吸做功增加而被收入新生儿重症监护病房(NICU)进一步治疗。117 例足月和近足月新生儿(平均胎龄=36.8 周)被确诊为表面活性物质缺乏性 SRDS。将 60 例胎龄小于 35 周的伴有 SRDS 的早产儿作为对照组(平均胎龄 27.5 周)。两组的平均出生体重分别为 2.8kg 和 1.1kg。SRDS 更常见于男性(58%),所有确诊病例中剖宫产率为 78.6%。28.2%的病例无明显病因,而所有病例中有 37.6%的母亲患有糖尿病,27%的母亲患有巨细胞病毒感染、绒毛膜羊膜炎或胎膜早破。

结论

足月和近足月新生儿(每 1000 例活产儿中有 10 例)中 SRDS 并不少见。到目前为止,最常见的相关危险因素是母亲糖尿病和剖宫产。它影响男性多于女性。大多数病例会出现轻度至中度病程,对无创通气有反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc6d/9828914/ea450e8956df/ACTA-93-337-g001.jpg

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