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目的探讨不同分娩方式对晚期早产儿呼吸系统疾病发生及预后的影响。方法以2010年1月-2015年12月在石嘴山市第一人民医院产科出生的晚期早产儿作为研究对象,将符合入选条件的早产儿按照出生胎龄分成34、35和36周3组,然后根据分娩方式再次进行分类,将选择性剖宫产(ECS)的252例早产儿作为ECS组,358例阴道分娩的早产儿作为阴道分娩组,124例急诊剖宫产的早产儿作为急诊剖宫产组。分析分娩方式与不同胎龄的晚期早产儿呼吸系统并发症发生及预后的相关性。结果 ECS组早产儿发生呼吸系统疾病105例,发病率41.7%,急诊剖宫产组早产儿发生呼吸系统疾病56例,发病率45.2%,与ECS组发病率比较,差异无统计学意义(P>0.05);358例阴道分娩的早产生儿发生呼吸系统疾病72例,发病率20.1%,ECS组比阴道分娩组具有更高的呼吸系统疾病发病率,差异有统计学意义(P<0.05)。34和35周组的晚期早产儿,ECS者比阴道分娩者呼吸窘迫综合征(RDS)发病率更高,差异有统计学意义(P<0.05);34、35及36周组的晚期早产儿RDS和湿肺(TTN)发病率比较均是ECS者比阴道分娩者更高,差异有统计学意义(P<0.05)。34、35及36周组的晚期早产儿ECS者与阴道分娩者相比,住院时间更长、新生儿重症监护室(NICU)入住率和持续正压通气(CPAP)使用率更高,差异有统计学意义(P<0.05)。结论 ECS和急诊剖宫产晚期早产儿呼吸系统疾病发病风险相当;相对于阴道分娩,ECS会增加晚期早产儿呼吸系统疾病发生率及预后不良,临床需尽量控制ECS率。
Objective To investigate the effects of different modes of delivery on the occurrence and prognosis of respiratory diseases in advanced preterm infants. Methods From January 2010 to December 2015 in Shizuishan First People’s Hospital of Obstetrics and Gynecology birth of the late preterm children as the research object will meet the inclusion criteria of preterm infants according to gestational age at 34, 35 and 36 weeks divided into 3 groups, and then According to the mode of delivery again classified 252 cases of selective cesarean section (ECS) preterm children as ECS group, 358 cases of vaginal delivery of preterm children as vaginal delivery group, 124 cases of emergency cesarean section of preterm children as emergency cesarean section Production group. To analyze the relationship between mode of delivery and respiratory complications and prognosis of late preterm infants with different gestational age. Results In the ECS group, 105 cases of respiratory diseases occurred in preterm infants, with an incidence rate of 41.7%. 56 cases of respiratory diseases in preterm infants in the emergency cesarean section group (45.2%) had no significant difference compared with the ECS group (P (P0.05) .Among 358 cases of vaginal delivery, 72 cases of respiratory diseases occurred in premature infants with the incidence of 20.1%. The incidence of respiratory diseases in ECS group was higher than that in vaginal delivery group, with significant difference (P0.05) . The incidence of respiratory distress syndrome (RDS) was higher in advanced preterm infants in 34 and 35 weeks group than in vaginal delivery in ECS patients (P <0.05). In preterm infants in 34, 35 and 36 weeks group, The incidence of RDS and wet lung (TTN) were higher in ECS than in vaginal delivery, the difference was statistically significant (P <0.05). Compared with vaginal delivery, ECS in late preterm infants at 34, 35 and 36 weeks had longer hospital stay, higher rates of neonatal intensive care unit (NICU) occupancy and continuous positive airway pressure (CPAP) Statistical significance (P <0.05). Conclusions ECS is equivalent to the risk of respiratory disease in emergency cesarean section. Compared with vaginal delivery, ECS can increase the incidence and prognosis of respiratory diseases in advanced preterm infants. The ECS rate should be controlled as much as possible.