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目的:探讨不同分娩方式对足月儿急性呼吸窘迫综合征(ARDS)发生率的影响,并探讨影响ARDS发生的危险因素。方法:回顾性分析2014年6月至2016年5月在本院出生的足月儿的临床资料,根据其母亲分娩方式分为择期剖宫产组、非择期剖宫产组和阴道分娩组。观察3组足月儿ARDS发生率的差异,比较不同临床特征足月儿ARDS发生率的差异,分析影响足月儿ARDS发生率的危险因素。结果:择期剖宫产组ARDS发生率为14.29%,明显高于非择期剖宫产组和阴道分娩组(均P<0.05);有窒息史、羊水吸入史、宫内窘迫史、孕母胎膜早破、孕母前置胎盘、孕母产前激素使用者的足月儿ARDS发生率较高,而不同性别足月儿和孕母是否合并糖尿病对足月儿ARDS发生无明显影响;将单因素分析有意义的窒息史、羊水吸入史、宫内窘迫史、孕母胎膜早破、孕母前置胎盘、孕母产前激素使用作为自变量,将足月儿是否发生ARDS作为因变量进行Logistic回归分析,结果显示羊水吸入史、宫内窘迫史和胎膜早破是影响足月儿发生ARDS的危险因素,OR值分别为4.023、3.852和4.122(P<0.05)。结论:择期剖宫产足月儿ARDS发生率较高,且与孕妇和胎儿多种因素有关,可根据具体情况选取择期剖宫产或阴道分娩方式。
Objective: To investigate the effect of different modes of delivery on the incidence of acute respiratory distress syndrome (ARDS) in term infants and to explore the risk factors influencing ARDS. Methods: Clinical data of full-term infants born in our hospital from June 2014 to May 2016 were retrospectively analyzed. According to their mode of delivery, they were divided into elective cesarean section group, elective cesarean section group and vaginal delivery group. The incidence of ARDS in three groups of full-term infants was observed. The differences of incidence of ARDS among different clinical features of full-term infants were compared. The risk factors of ARDS in term infants were analyzed. Results: The incidence of ARDS in elective cesarean section group was 14.29%, significantly higher than that in elective cesarean section group and vaginal delivery group (all P <0.05). There was a history of asphyxia, history of amniotic fluid imbalance, history of intrauterine distress, Premature rupture, placenta previa, gestational age preterm hormones users of full-term ARDS incidence higher, and different sex full-term infants and pregnant women with diabetes mellitus had no effect on ARDS full-term infants; single Factor analysis of meaningful history of asphyxia, amniotic fluid history of inhalation, intrauterine distress history, premature rupture of membranes, prenatal placenta previa, prenatal hormone use as independent variables, full-term children ARDS as the dependent variable occurred Logistic regression analysis showed that history of inhalation of amniotic fluid, history of intrauterine distress and premature rupture of membranes were the risk factors for ARDS in full-term infants. The OR values were 4.023, 3.852 and 4.122, respectively (P <0.05). Conclusions: The incidence of ARDS in full-term cesarean section is higher than that of pregnant women and fetus. Elective cesarean section or vaginal delivery can be selected according to the specific conditions.