目的了解晚期早产儿和足月儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的临床特征,提高对该病的认识。方法将皖北煤电集团总医院新生儿病房2004年1月-2011年9月收治的32例胎龄≥34周的晚期早产儿或足月儿RDS为研究对象,即晚期早产儿-足月儿组;同期收治的胎龄<34周早产儿RDS 36例为对照组,即早产儿组。对两组患儿的病因、临床表现、治疗措施和并发症等资料进行对比分析。结果①两组发生RDS的病因不同:早产儿以早产为主要病因,晚期早产儿或足月儿以选择性剖宫产、围生期窒息、胎粪吸入等为主要原因。②晚期早产儿和足月儿发生RDS应用呼吸机时间较晚,应用常规剂量外源性肺表面活性物质(PS)24 h后氧和指数(OI)较早产儿高(P<0.05)。结论晚期早产儿-足月儿RDS病因以产程未发动的择期剖宫产和围生期窒息为主,开始应用呼吸机治疗的时间晚,且应用外源性PS效果不如早产儿好。晚期早产儿或足月儿RDS易并发新生儿持续肺动脉高压(PPHN)、气漏综合征和多脏器功能衰竭等并发症。 Objective To understand the clinical features of respiratory distress syndrome (RDS) in advanced preterm infants and term infants and to improve their understanding of the disease. Methods 32 cases of late preterm or term RDS of gestational age ≥34 weeks admitted to neonatal ward of Wanbei Coal and Metallurgical General Hospital from January 2004 to September 2011 were studied. In the same period, 36 cases of premature infants with gestational age <34 weeks were enrolled as control group, ie premature infants. The etiology, clinical manifestations, treatment measures and complications of two groups of children were compared. Results ① The causes of RDS in the two groups were different: premature infants were the major causes of preterm birth, late cesarean section or full-term infants were mainly cesarean section, perinatal asphyxia and meconium aspiration. (2) RDS ventilator was late in preterm and term infants. Oxygen and index (OI) were higher in preterm infants and term infants than those in preterm infants after routine dose of exogenous pulmonary surfactant (PS) for 24 h (P <0.05). Conclusions The causes of RDS in term premature infants and full-term infants are mainly elective cesarean section and perinatal asphyxia, which are not triggered by labor, and are started to be treated with ventilator late. The effect of exogenous PS is not as good as that of premature infants. Late preterm or term infants with RDS complicated with neonatal persistent pulmonary hypertension (PPHN), air leak syndrome and multiple organ failure and other complications.