基于“蒙特勒标准”的新生儿急性呼吸窘迫综合征的临床特征和危险因素分析

Abstract
Figure/Table
References (25)
Related Citation (15)

Download: PDF (641 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To analyze the clinical features and risk factors of neonatal acute respiratory distress syndrome(ARDS)based on the “Montreux Standard”.Methods The total number of newborns hospitalized at Huai′an Maternal and Child Health Center affiliated to Yangzhou University Medical College from January to December 2019 was 3930,of which 964 newborns with dyspnea symptoms were selected as subjects.According to “Montreux standard”,they were divided into the ARDS group (204 cases) and the non ARDS group (760 cases).The etiology,clinical characteristics and risk factors of ARDS were analyzed.Results In 2019,children with dyspnea symptoms in our hospital accounted for 24.5% (964/3930) of the newborns admitted in the same period,and children with ARDS accounted for 5.2% (204/3930) of the newborns admitted in the same period,and which were 76 cases(37.3%)with mild ARDS,69 cases(33.8%)with moderate ARDS,and 59 cases (28.9%) with severe ARDS.The gestational age and birth weight of neonates in the ARDS group were lower than those in the non-ARDS group,and the differences were statistically significant (P＜0.05).Neonatal asphyxia,pregnancy complications,infection,surgery,Downes score,oxygenation index (OI),mechanical ventilation,assisted ventilation time,use of alveolar surfactant (PS),use of nitric oxide (NO),complications in the ARDS group were all higher than those in the non-ARDS group,and the differences were statistically significant (P＜0.05).Multivariate Logistic regression analysis showed that infection,asphyxia,surgery,PS deficiency and high Downes score were risk factors for ARDS (P＜0.05).Conclusion The main causes of neonatal ARDS are infection,asphyxia,surgery,meconium and milk inhalation.Infection,asphyxia,surgery,PS deficiency and high Downes score are risk factors for ARDS.

Key words： Dyspnea Acute respiratory distress syndrome Newborn Pathogen Risk factors

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	XU Hui
	LIU Xuan
	PAN Zhaojun
	WU Rong

Cite this article:

XU Hui,LIU Xuan,PAN Zhaojun, et al. Analysis of clinical characteristics and risk factors of neonatal acute respiratory distress syndrome based on the “Montreux Standard”[J]. 中国当代医药, 2022, 29(14): 110-114.

URL:

https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I14/110

[1]	De Luca D，van Kaam AH，Tingay DG，et al.The Montreux definition of neonatal ARDS：biological and clinical background behind the description of a new entity[J].Lancet Respir Med，2017，5（8）：657-666.
[2]	郭静雨，陈龙，史源.2017年新生儿急性呼吸窘迫综合征蒙特勒诊断标准解读[J].中华儿科杂志，2018，56（8）：571-574.
[3]	唐烁，包蕾.新生儿急性呼吸窘迫综合征临床特征与预后相关因素分析[J].第三军医大学学报，2019，41（9）：898-902.
[4]	邵肖梅，叶鸿瑁，丘小汕，等.实用新生儿学[M].5 版.北京：人民卫生出出版社，2018.
[5]	武荣，封志纯，刘石.新生儿呼吸窘迫评分[M]//新生儿诊疗技术进展.北京：人民卫生出版社，2016：105-108.
[6]	刘弦，杭昱，胡金绘，等.1135 例新生儿呼吸困难的病因、特点和危险因素分析[J].中国医药导报，2019，16（36）：100-103.
[8]	王丹华.对Apgar 评分的再认识[J].中华围产医学杂志，2021，24（3）：165-168.
[7]	Hammoud MS，Raghupathy R，Barakat N，et al.Cytokine profiles at birth and the risk of developing severe respiratory distress and chronic lung disease[J].J Res Med Sci，2017，22：62.
[9]	蒋清爱.Apgar 评分、脐血动脉血气分析在新生儿窒息评价中的应用价值研究[J].重庆医学，2021，50（1）：259-261.
[10]	Moshiro R，Mdoe P，Perlman JM.A global view of neonatal asphyxia and resuscitation[J].Front Pediatr，2019，7：489.
[11]	Fan E，Brodie D，Slutsky AS，et al.Acute Respiratory Distress Syndrome：Advances in Diagnosis and Treatment[J].JAMA，2018，319（7）：698-710.
[12]	杨倩，梁璐.呼吸机相关性肺损伤及机械能[J].医学研究和教育，2020，37（6）：14-22.
[13]	The Pediatric Acute Lung Injury Consensus Conference Group.Pediatric acute respiratory distress syndrome：consensus recommendations from the pediatric acute lung injury consensus conference[J].Pediatr Crit Care Med，2015，16（5）：428-439.
[14]	钟静，顾佳慧，周修适，等.肺保护性通气策略研究进展[J].现代实用医学，2021，33（7）：841-846.
[15]	Seethala RR，Hou PC，Aisiku IP，et al.Early risk factors and the role of fluid administration in developing acute respiratory distress syndrome in septic patients[J].Ann Intensive Care，2017，7（1）：11.
[16]	邹远霞，张家瑜，周波，等.新生儿急性呼吸窘迫综合征诊疗研究进展[J].医学研究杂志，2021，50（3）：129-132.
[17]	封志纯，赵喆，史源.读懂新生儿急性呼吸窘迫综合征的关键词：叠加[J].中华围产医学杂志，2021，24（4）：273-277.
[18]	洪小杨，封志纯.重度儿科急性呼吸窘迫综合征临床救治的出路[J].中华儿科杂志，2018，56（5）：324-326.
[19]	Hong X，Zhao Z，Liu Z，et al.Venoarterial extracorporeal membrane oxygenation for severe neonatal acute respiratory distress syndrome in a developing country[J].Front Pediatr，2020，8：227.
[20]	Cools F，Offringa M，Askie LM.Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants[J].Cochrane Database Syst Rev，2015，（3）：CD000104.
[21]	邢凯慧，王琦，宋依瑾，等.高频振荡通气联合肺表面活性剂治疗新生儿急性呼吸窘迫综合征的效果及对氧合功能的影响[J].中华实用诊断与治疗杂志，2019，33（9）：895-898.
[22]	周晓光，洪慧.新生儿急性呼吸窘迫综合征的治疗进展[J].中华实用儿科临床杂志，2017，32（2）：81-84.
[23]	郭静雨，陈龙，史源.基于“蒙特勒标准”的新生儿急性呼吸窘迫综合征的单中心回顾性研究[J].中华当代儿科杂志，2020，22（12）：1267-1272.
[24]	陈龙，史源.新生儿急性呼吸窘迫综合征：从概念到实践[J].中华实用儿科临床杂志，2019，34（18）：1364-1367.
[25]	董声焕.急性呼吸窘迫综合征与肺表面活性物质[J].小儿急救医学，2000，7（3）：121-123.