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目的：观察早产儿肺透明膜病（ＨＭＤ）临床特点与多器官损害的关系，胎儿宫内失血和宫内缺氧的临床特点、多器官损害和对预后的影响。方法：早产儿ＨＭＤ中宫内缺氧缺血组１０８例，出生后缺氧组４６例；死亡病例均经尸检确诊。ＨＭＤ均检测血气、心电图、多项生化指标，并摄胸腹部Ｘ线片。结果：１５４例ＨＭＤ中普通型１０２例，休克型５２例。多器官损害率：普通型６５６９％（６７／１０２），休克型９０３８％（４７／５２）。病死率：普通型４７０６％（４８／１０２），休克型９４２３％（４９／５２）。休克发生率分别为胎儿缺氧缺血组４６３０％（５０／１０８），出生后缺氧组４３５％（２／４６）。结论：胎儿宫内失血和宫内缺氧是导致早产儿ＨＭＤ并发休克、多器官损害最危险的病理因素，对预后影响极为严重，应引起高度重视。
OBJECTIVE: To observe the relationship between the clinical features and the multiple organ damage in preterm infants with hyaline membrane disease (HMD), the clinical features of intrauterine blood loss and intrauterine hypoxia, the damage of multiple organs and the prognosis. Methods: 108 cases of intrauterine hypoxia and ischemia in preterm infants with HMD and 46 cases of hypoxia after birth were killed. All the dead cases were confirmed by autopsy. HMD were detected blood gas, electrocardiogram, a number of biochemical indicators, and chest X-ray film. Results: There were 102 cases of common type and 52 cases of shock type in 154 cases of HMD. Multiple organ damage rates were 65.69% (67/102) for common type and 90.38% (47/52) for shock type. Case fatality rate was 4706% (48/102) in general type and 9423% (49/52) in shock type. The rates of shock were 4630% (50/108) in fetal hypoxic-ischemic group and 435% (2/46) in hypoxic group after birth respectively. Conclusion: Fetal intrauterine blood loss and intrauterine hypoxia are the most dangerous pathological factors leading to HMD complicated by shock and multiple organ damage in preterm infants, which have a very serious effect on prognosis and should be highly valued.