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目的探讨聊城市人民医院新生儿重症监护室(NICU)中不同胎龄新生儿呼吸衰竭(NRF)的临床特点,为合理诊治提供依据。方法选择2010—2011年我院NICU收治的NRF患儿,根据胎龄分为≤32周组、33～36周组和≥37周组,对各组新生儿的围产期情况、疾病分布状况、呼吸机辅助通气方式、通气时间、辅助通气并发症、住院时间、费用及预后进行回顾性总结,以反映我院NICU新生儿呼吸危重病的救治状况。结果 2年间我院NICU共收治新生儿3077例,NRF870例,占同期住院患儿的28.3%;主要原发疾病包括新生儿呼吸窘迫综合征(RDS)和(或)严重湿肺398例(45.7%),新生儿肺炎224例(25.7%),新生儿窒息163例(18.7%)。870例患儿中,早产儿502例,占57.7%;痰培养阳性157例,占18.0%;合并持续肺动脉高压99例(11.4%),合并气胸14例(1.6%);治愈558例(64.1%),好转105例(12.1%),死亡47例(5.4%),放弃160例(18.4%);住院时间(14.2±8.8)天。结论 NRF是本院NICU的重要疾病,原发病以RDS和(或)严重湿肺为首,足月儿RDS有增多趋势,与择期剖宫产、羊水污染有关,容易并发持续肺动脉高压,应引起重视。开展针对早产儿及RDS救治的新技术有利于提高NRF的救治成功率,降低病死率。
Objective To investigate the clinical features of neonatal respiratory failure (NRF) in neonatal intensive care unit (NICU) of Liaocheng People’s Hospital and provide the basis for reasonable diagnosis and treatment. Methods From 2010 to 2011 in our hospital NICU admitted NRF children, according to gestational age were divided into group ≤ 32 weeks, 33 to 36 weeks and ≥ 37 weeks group, the perinatal status of each group of newborns, the distribution of disease Ventilator-assisted ventilation, ventilation time, assisted ventilation complications, hospitalization time, cost and prognosis were retrospectively summarized to reflect the treatment of NICU neonatal respiratory critically ill patients. Results In 2 years, NICU in our hospital treated 3077 newborns and 870 NRFs, accounting for 28.3% of the hospitalized children in the same period. The main primary diseases were neonatal respiratory distress syndrome (RDS) and severe wet lung (398 cases, 45.7% %), 224 cases of neonatal pneumonia (25.7%), neonatal asphyxia 163 cases (18.7%). Among 870 infants, preterm infants accounted for 57.7%; sputum culture positive 157 cases (18.0%); continuous pulmonary hypertension in 99 cases (11.4%) and pneumothorax in 14 cases (1.6%); cured 558 cases (64.1% %), Improvement in 105 cases (12.1%), death in 47 cases (5.4%), giving up 160 cases (18.4%); hospitalization time (14.2 ± 8.8) days. Conclusion NRF is an important disease of NICU in our hospital. RDS and / or severe wet lung are the main cause of this disease. There is an increasing trend of RDS in term infants, which is related to elective cesarean section and amniotic fluid contamination. Concurrent NRF should be caused Pay attention. To carry out new technologies for premature infants and RDS treatment is conducive to improve the success rate of NRF treatment, reduce mortality.