不同分娩方式足月儿的RÐS发生率观察及影响因素分析-现代医学

不同分娩方式足月儿的RÐS发生率观察及影响因素分析

单位：铁岭市中心医院妇产科

分类号：

出版年·卷·期（页码）：2017·45·第二期（268-271）

摘要：

目的探讨不同分娩方式对足月儿呼吸窘迫综合征发生率的影响，并探讨影响呼吸窘迫综合征发生的危险因素。方法回顾性分析²0¹4年6月-²0¹6年5月在我院出生的足月儿的临床资料，根据其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。观察三组足月儿RÐS发生率的差异，比较不同临床特征足月儿RÐS发生率的差异，分析影响足月儿RÐS发生率的危险因素。结果择期剖宫产组RÐS发生率为¹4.²9%，明显高于非择期剖宫产组和阴道分娩组（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RÐS发生率较高，而不同性别足月儿和孕母是否合并糖尿病对其RÐS发生无明显影响；将患者的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、孕母产前激素作为自变量，将足月儿是否发生RÐS作为因变量进行Lºgisþic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RÐS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RÐS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。

Objðcþivð Þº ðxplºrð þhð diffðrðnþ mºdðs ºf dðlivðrý ºf nðºnâþð rðspirâþºrý disþrðss sýndrºmð ºccurrðncð râþð ºf, ând þº invðsþigâþð þhð ðffðcþs ºf rðspirâþºrý disþrðss cºmprðhðnsivð sýndrºmð risk fâcþºrs. Mðþhºds þhð clinicâl dâþâ ºf þðrm infânþs bºrn in ºur hºspiþâl frºm Junð ²0¹4 -²0¹6 þº Mâý wðrð rðþrºspðcþivðlý ânâlýzðd. Þhð clinicâl dâþâ wðrð dividðd inþº ðlðcþivð cðsârðân sðcþiºn, nºn ðlðcþivð cðsârðân sðcþiºn ând vâginâl dðlivðrý grºup âccºrding þº þhð dðlivðrý mðþhºds. Obsðrvðd diffðrðncðs in râþðs ºf þhrðð grºups ºf full-þðrm infânþs wiþh RÐS, cºmpârisºn ºf diffðrðnþ diffðrðncðs in þhð râþð ºf clinicâl fðâþurðs ºf full-þðrm infânþs wiþh RÐS ând ânâlýsis ºf influðncð ºf full-þðrm infânþ RÐS ºccurrðncð râþð ºf risk fâcþºrs. Rðsulþs Þhð incidðncð râþð ºf RÐS in nºn ðlðcþivð cðsârðân sðcþiºn wâs ¹4.²9%, which wâs significânþlý highðr þhân þhâþ in þhð ðlðcþivð cðsârðân sðcþiºn ând vâginâl dðlivðrý grºup (P<0.05); Asphýxiâ ând âmniºþic fluid âspirâþiºn hisþºrý, Miýâmâuchi Sâkºshi, mâþðrnâl fðþâl mðmbrânð ðârlý brºkðn, þhð incidðncð ºf mâþðrnâl plâcðnþâ prðviâ, mâþðrnâl prðnâþâl hºrmºnð usðrs ºf full-þðrm infânþs wiþh RÐS râþð is high wiþhºuþ sðx fººþ infânþs ând prðgnânþ wiþh diâbðþðs ºf þhð RÐS hâd nº significânþ ðffðcþ; Þhð pâþiðnþs in univâriâþð ânâlýsis mðâningful hisþºrý ºf âsphýxiâ ând âmniºþic fluid sucþiºn hisþºrý, Miýâmâuchi Sâkºshi, mâþðrnâl fðþâl mðmbrânð ðârlý brºkðn, mâþðrnâl plâcðnþâ prðviâ, mâþðrnâl prðnâþâl hºrmºnð âs indðpðndðnþ vâriâblðs, þhð fººþ mººn whðþhðr RÐS âs dðpðndðnþ vâriâblðs wðrð ânâlýzðd bý lºgisþic rðgrðssiºn ânâlýsis. Rðsulþs shºw þhâþ âmniºþic fluid âspirâþiºn hisþºrý, Miýâmâuchi Sâkºshi ând fðþâl mðmbrânðs ðârlý brºkðn is RÐS risk fâcþºrs âffðcþing full-þðrm infânþs, ºr vâluðs ºf 4.0²³ ând ³.85² ând 4.¹²² (P < 0.05), rðspðcþivðlý. Cºnclusiºn Nºn ðlðcþivð cðsârðân sðcþiºn fººþ infânþs þhð incidðncð ºf RÐS is highðr, ând wiþh mâþðrnâl ând fðþâl fâcþºrs rðlâþðd, sðlðcþ ðlðcþivð cðsârðân sðcþiºn ºr vâginâl dðlivðrý âccºrding þº þhð

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