Analysis Of 141 Cases Of Neonatal Respiratory Distress Syndrome

Objective:To explore the morbidity and the risk factors,as well as the prognosis of neonatal respiratory distress syndrome(RDS),we retrospectively analyzed the clinical data of neonatal RDS in our NICU for past 4 years.The early preterm infants were divided into groups to analyze the prognostic risk factors.Throught it,we can further standardize the diagnosis and treatment of neonatal RDS,and then improve the prognosis of neonatal RDS in our NICU.Meathods : The clinical data of neonatal RDS,who born in the First Affiliated Hospital of Guangxi Medical University and hospitalized in NICU from January 2013 to December 2016 were recruited and analyzed.In addition,77 cases of neonatal RDS,whose GA < 32 weeks were divided into better prognosis group and poor prognosis group according to the conditions at the time of discharge,and then analyze the risk factors affecting the prognosis.Results:1.Total 141 cases of neonatal RDS were collected from 2013 to 2016 born in our hospital.The annual morbidity of the 4 years was 0.76%?1.05%?1.02% and1.58% respectively,which is on the rise..The distribution of neonatal RDS among GA<32?32?GA<34?34?GA<37?GA?37were 58.2%?24.8%?12.8%?4.2%,respectively.The common complications occurred in neonatal RDS were pneumonia 55.3%?PVH-IVH 49.6%?sepsis 30.5%?ROP 29.6%?BPD 17.0% ? PDA 12.8% ? pulmonary hemorrhage 6.4% ? PPHN 2.8% ?pneumo-thorax 2.8% ? NEC 2.1%.The effective rate of prenatal use of glucocorticoid of RDS with GA<34 was36.8%;In our study,the pulmonary surfactant(PS)usage was 81.6%,the success rate of supported with CPAP or oxygen support was 34%,and 66% of cases required ventilator supportive therapy.116 cases of neonatal RDS were improved and discharged from hospital in 4 years.The cure rates for each year was : 68.2%(2013)? 90.6%(2014)? 80.6%(2015)? 83.9%(2016),20 cases were died or abandon treatment,which including 16 cases of GA<32(80%),5 cases of abnormal discharge.2.Through analysis the neonatal RDS with GA<32 weeks,we found that the gestational age and birth weight of poor prognosis group were lower than the improvement group,and the prevalence of pulmonary hemorrhage and gestational diabetes were higher than the improvement group,the difference is significant(P<0.01);The logistic regression analysis shows that pulmonary hemorrhage and gestational diabetes were the risk factors for poor outcome,and the GA is a protective factor.Conclusion:1.The morbidity of RDS in newborn is on the rise annually,among of which,early premature infants with GA<32 weeks are the main population with poor outcome.2.Gestational diabetes,small gestational age and neonatal pulmonary hemorrhage are important causes of poor prognosis of early premature infants with RDS.