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- Title
重度胎粪吸入综合征并发急性呼吸窘迫 综合征临床特征及转归分析.
- Authors
何晓光; 黄天丽; 徐凤丹; 谢浩强; 李金凤; 谢彩璇
- Abstract
Objective To study the clinical features and prognosis of neonates with severe meconium aspiration syndrome (MAS) and acute respiratory distress syndrome (ARDS). Methods A retrospective analysis was performed on the medical data of 60 neonates with severe MAS who were admitted from January 2017 to December 2019. According to the presence or absence of ARDS, they were divided into two groups: ARDS (n=45) and non-ARDS (n= 15). Clinical features and prognosis were compared between the two groups. Results Among the 60 neonates with severe MAS, 45 (75%) developed ARDS. Arterial blood gas analysis showed that the ARDS group had a significantly higher median oxygenation index within 1 hour after birth than the non-ARDS group (4.7 vs 2.1, P<0.05), while there was no significant difference between the two groups in white blood cell count, C-reactive protein (CRP), and interleukin-6 (IL-6) on admission and the peak values of procalcitonin, CRP, and IL-6 during hospitalization (P>0.05). The ARDS group had a significantly higher incidence rate of shock than the non-ARDS group (84% vs 47%, P<0.05). There was no significant difference between the two groups in the incidence rates of persistent pulmonary hypertension, pneumothorax, pulmonary hemorrhage, hypoxic-ischemic encephalopathy, intracranial hemorrhage, and disseminated intravascular coagulation (P>0.05). The ARDS group required a longer median duration of mechanical ventilation than the non-ARDS group (53 hours vs 3 hours, P<0.05). In the ARDS group, 43 neonates (96%) were cured and 2 neonates (4%) died. In the non-ARDS group, all 15 neonates (100%) were cured. Conclusions Neonates with severe MAS and ARDS tend to develop respiratory distress earlier, require a longer duration of mechanical ventilation, and have a higher incidence rate of shock. During the management of children with severe MAS, it is recommended to closely monitor oxygenation index, give timely diagnosis and treatment of ARDS, evaluate tissue perfusion, and actively prevent and treat shock.
- Subjects
MECONIUM aspiration syndrome; LEUKOCYTE count; ADULT respiratory distress syndrome; DISSEMINATED intravascular coagulation; PULMONARY hypertension; PNEUMOTHORAX; CEREBRAL anoxia-ischemia
- Publication
Chinese Journal of Contemporary Pediatrics, 2021, Vol 23, Issue 9, p903
- ISSN
1008-8830
- Publication type
Article
- DOI
10.7499/j.issn.1008-8830.2106121