A Analysis Study On Clinical Data Of 486 Cases With Respiratory Distress Syndrome In Full-term Neonates

Objective:To retrospectively analyze the clinical data in full-term newborns with neonatal respiratory distress syndrome,ascertain clinical characteristics among the selected full-term NRDS?NARDS and non-NARDS group,and provide new ideas for clinical precise treatment and carry out prospective multi-center research of such diseases.Methods:According to the diagnostic criteria for NRDS,a total of 486 full-term infants with NRDS were collected in our hospital from January 2012 to December 2018.According to neonatal ARDS Montreux diagnostic criteria,239 full-term NARDS cases were screened.According to the inclusion criteria,486 cases were divided into full-term NARDS group and full-term non-NARDS group.The clinical data were collected by formulating the clinical data observation table,including perinatal factors,clinical manifestations,pathogenic bacteria,lung imaging features,common complications and clinical outcomes.SPSS 20.0 was used for statistical analysis of the data.Result:1.The order of 486 full-term NRDS perinatal factors from high to low was cesarean section,male,abnormal amniotic fluid,abnormal umbilical cord,pregnant women with gestational diabetes,upper respiratory tract infection during pregnancy,intrauterine infection,premature rupture of membranes,Intrauterine distress,asphyxia at birth,high blood pressure during pregnancy,anemia in pregnant women,abnormal placenta,meconium aspiration,vaginitis,hemolytic disease of newborn,chorionic Amnionitis.2.The high-risk factors of full-term NARDS included intrauterine distress,premature rupture of membranes,meconium aspiration,and intrauterine infection,and The relative degree was intrauterine infection(OR=25.015)>meconium aspiration(OR=9.617)>intrauterine Distress(OR=3.189)>premature rupture of membranes(OR=2.438);the high-risk factors of the full-term non-NARDS included men,cesarean section,and gestational diabetes,and The relative degree was cesarean section(OR=1.912)>men(OR=1.410)>gestational diabetes(OR=1.004).3.The clinical manifestations of 486 full-term NRDS children in order from high to low were dyspnea,bruising,poor response,low muscle tone,yellow skin,edema,fever,or low body temperature.The poor response and low muscle tone in the full-term NARDS group were significantly higher than those in the non-NARDS group,and the difference between the two groups was statistically significant(P<0.05).4.486 full-term newborns with NRDS were cultured with 92 pathogenic bacteria,29 G+bacteria,61 G-bacteria,and 2 fungi;the top three were Klebsiella pneumoniae,Streptococcus agalactiae,and Bowman Acinetobacter and Escherichia coli.The top three in the term NARDS group were Klebsiella pneumoniae,Streptococcus agalactiae,and Escherichia coli;the top three non-NARDS in term were Klebsiella pneumoniae,streptococcus agalactiae,and staphylococcus epidermidis.In NARDS group,Streptococcus agalactiae,Klebsiella pneumoniae,Acinetobacter baumannii,and Escherichia coli were significantly higher than term non-NARDS,and the difference between the two groups was statistically significant(P<0.05).5.There were 207(42.6%)cases of bilateral diffuse irregular transmittance reduction or exudation,47(9.7%)cases of Grade ?;161(33.1%))Cases of Grade ? to ?;71(14.6%)cases of white lung in 486 full-term NRDS chest radiographs.Full-term diffuse irregular light transmittance decreased or exuded in the full-term NARDS group was significantly higher than that in the full-term non-NARDS group,and the RDS of the lungs in the full-term non-NARDS group was significantly higher than that of the full-term NARDS group;the difference between the two groups was statistically significant(P<0.05);the difference between the two groups with white lungs was not statistically significant(P>0.05).6.Common complications of 486 full-term NRDS were hypocalcemia,anemia,hypokalemia,pulmonary hypertension,myocardial injury,intracranial hemorrhage,air leak syndrome,gastrointestinal bleeding,hypoglycemia,DIC.Full-term NARDS group was significantly higher than non-NARDS group in pulmonary hypertension,air leak syndrome,intracranial hemorrhage,gastrointestinal bleeding,anemia,hypokalemia,hypocalcemia,DIC,myocardial injury;the difference between two groups was statistically significant(?2=P<0.05).There was no significant difference in hypoglycemia between the two groups(P>0.05).7.486 full-term NRDS cases,237(48.8%)cases were cured,200(41.1%)cases were improved,and 49(3.9%)cases were died.The mortality rate of the full-term NARDS group was significantly higher than that of the non-NARDS group,and there was a statistically significant difference between the two groups(P<0.05).Conclusion:1.The high-risk factors for full-term NRDS in the study population included cesarean section,men,abnormal amniotic fluid,abnormal umbilical cord,pregnant women with gestational diabetes,upper respiratory tract infection during pregnancy,intrauterine infection,premature rupture of membranes,intrauterine Distress,choking at birth,hypertension during pregnancy,anemia in pregnant women,abnormal placenta,meconium aspiration,vaginitis,hemolytic disease of the newborn,chorioamnionitis,especially the top five.2.The risk factors for full-term NARDS in the study population included intrauterine distress,premature rupture of membranes,meconium aspiration,intrauterine infection.The risk factors for full-term non-NARDS included men and cesarean section,Gestational diabetes.3.The main pathogens in full-term NRDS research group were Klebsiella pneumoniae,Streptococcus agalactiae,Acinetobacter baumannii,and Escherichia coli.In NARDS group,Streptococcus lactis,Klebsiella pneumoniae,Acinetobacter baumannii,and Escherichia coli were significantly higher than non-NARDS.4.The clinical manifestations of the full-term NARDS group were not significantly different from those of the full-term non-NARDS group,while the lungs imaging characteristics were very different 5.The common complication and mortality of full-term NARDS in the study group were higher than those in the non-ARDS group.6.Full-term NRDS was divided into full-term NARDS and full-term non-NARDS,which provided new ideas for the clinical precision treatment and prospective multicenter research.