切换至 "中华医学电子期刊资源库"

中华产科急救电子杂志 ›› 2018, Vol. 07 ›› Issue (04) : 225 -229. doi: 10.3877/cma.j.issn.2095-3259.2018.04.008

所属专题: 文献

专家论坛

早产儿呼吸窘迫综合征的早期预防和治疗
叶晓彤1, 杨传忠1,()   
  1. 1. 518028 深圳,南方医科大学深圳妇幼保健院新生儿科
  • 收稿日期:2018-08-08 出版日期:2018-11-18
  • 通信作者: 杨传忠
  • 基金资助:
    深圳市"医疗卫生三名工程"资助项目(SZSM201612045)

Early prevention and treatment of respiratory distress syndrome in premature infants

Xiaotong Ye1, Chuanzhong Yang1()   

  • Received:2018-08-08 Published:2018-11-18
  • Corresponding author: Chuanzhong Yang
引用本文:

叶晓彤, 杨传忠. 早产儿呼吸窘迫综合征的早期预防和治疗[J]. 中华产科急救电子杂志, 2018, 07(04): 225-229.

Xiaotong Ye, Chuanzhong Yang. Early prevention and treatment of respiratory distress syndrome in premature infants[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2018, 07(04): 225-229.

早产儿呼吸窘迫综合征(neonatal respiratory distress syndrome, RDS)通常发生于胎龄较小的极低或超低出生体重儿,主要原因是肺表面活性物质合成少和肺发育不成熟。目前外源性肺表面活性物质的替代治疗是防治早产儿RDS的主要手段,此外,产前预防、产房复苏策略以及出生后早期呼吸支持治疗等综合措施也对该病的预防和治疗起着极为重要的作用。本文主要对早产儿RDS的预防及治疗措施进行讨论。

Neonatal respiratory distress syndrome (RDS) usually occurs in very low or ultra-low birth weight infants with small gestational age, mainly due to low synthesis of pulmonary substances and immature lung development. At present, the substitution therapy of exogenous pulmonary surfactant is the main method to prevent and treat premature infants with RDS. In addition, prenatal prevention, resuscitation strategy and early postnatal respiratory support therapy also play an important role in the prevention and treatment of the disease. This paper reviews the prevention and treatment of respiratory distress syndrome in premature infants.

[1]
薛辛东. 新生儿呼吸疾病∥桂永浩,薛辛东. 儿科学[M]. 3版. 北京:人民卫生出版社,2017: 112-121.
[2]
中国城市多中心早产儿呼吸窘迫综合征调查协作组. 住院分娩早产儿呼吸窘迫综合征:中国13家医院的回顾性调查[J]. 中华围产医学杂志,2016, 19(10): 743-754.
[3]
Sweet DG, Carnielli V, Greisen G, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome-2016 Update[J]. Neonatology, 2017, 111(2): 107-125.
[4]
Ramachandrappa A, Jain L. Elective cesarean section: its impact on neonatal respiratory outcome [J]. Clin Perinatol, 2008, 35(2): 373-393.
[5]
Anadkat JS, Kuzniewicz MW, Chaudhari BP, et al., Increased risk for respiratory distress among white, male, late preterm and term infants [J]. J Perinatol, 2012, 32(10): 780-785.
[6]
Liu J, Yang N, Liu Y. High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study [J]. Balkan Med J, 2014, 31(1): 64-68.
[7]
Hallman M, Haataja R, Marttila R. Surfactant proteins and genetic predisposition to respiratory distress syndrome [J]. Semin Perinatol, 2002, 26(6): 450-460.
[8]
Jiang L, Wu YD, Xu XF, et al. Polymorphism analysis of the ABCA3 gene: association with neonatal respiratory distress syndrome in preterm infants [J]. Chin Med J (Engl), 2012, 125(9): 1594-1598.
[9]
Wambach JA, Wegner DJ, Depass K, et al., Single ABCA3 mutations increase risk for neonatal respiratory distress syndrome [J]. Pediatrics, 2012, 130(6): e1575-e1582.
[10]
Demirçubuk AG, Coçkun MY, Demiryürek Ş, et al. Endothelial NOS gene Glu298Asp polymorphism in preterm neonates with respiratory distress syndrome [J]. Pediatr Pulmonol, 2013, 48(10): 976-980.
[11]
Ataseven F, Salis O, Aygun C, et al. Clinical significance of glucocorticoid receptor expression in premature infants with respiratory distress syndrome [J]. J Matern Fetal Neonatal Med, 2017, 30(4): 430-433.
[12]
中国医师协会新生儿科医师分会,《中华围产医学杂志》编辑委员会. 早产儿呼吸窘迫综合征早期防治专家共识[J]. 中华围产医学杂志,2017, 20(8): 557-559
[13]
Kenyon S, Boulvain M, Neilson JP. Antibiotics for preterm rupture of membranes [J]. Cochrane Database Syst Rev, 2013, 12: CD001058.
[14]
Liggins GC. Thyrotrophin-releasing hormone (TRH) and lung maturation [J]. Reprod Fertil Dev, 1995, 7(3): 443-450.
[15]
谈晓洁,窦彩艳. 产前预见性应用盐酸氨溴索在预防新生儿呼吸窘迫综合征的效果观察[J]. 中国现代药物应用,2015, 9(6): 179-180.
[16]
李金嫦,陈志云. 新生儿呼吸窘迫综合征应用盐酸氨溴索治疗的临床分析[J]. 当代医学,2014, 20(18): 100-101.
[17]
Vali P, Mathew B, Lakshminrusimha S. Neonatal resuscitation: evolving strategies[J]. Matern Health Neonatol Perinatol, 2015. 1. pii: 4.
[18]
Chiruvolu A, Qin H, Nguyen ET, et al. The Effect of Delayed Cord Clamping on Moderate and Early Late-Preterm Infants [J]. Am J Perinatol, 2018, 35(3): 286-291.
[19]
Wiberg N, Källén K, Olofsson P. Delayed umbilical cord clamping at birth has effects on arterial and venous blood gases and lactate concentrations[J]. BJOG, 2008, 115(6): 697-703.
[20]
Valero J, Desantes D, Perales-Puchalt A, et al. Effect of delayed umbilical cord clamping on blood gas analysis [J]. Eur J Obstet Gynecol Reprod Biol, 2012, 162(1): 21-23.
[21]
Aladangady N, McHugh S, Aitchison TC, et al. Infants′ blood volume in a controlled trial of placental transfusion at preterm delivery [J]. Pediatrics, 2006, 117(1): 93-98.
[22]
Schmölzer GM, Kumar M, Aziz K, et al. Sustained inflation versus positive pressure ventilation at birth: a systematic review and meta-analysis [J]. Arch Dis Child Fetal Neonatal Ed, 2015, 100(4): F361-F368.
[23]
Wright CJ, Polin RA, Kirpalani H. Continuous Positive Airway Pressure to Prevent Neonatal Lung Injury: How Did We Get Here, and How Do We Improve?[J]. J Pediatr, 2016, 173: 17-24.
[24]
Te Pas AB, Walther FJ. A randomized, controlled trial of delivery-room respiratory management in very preterm infants [J]. Pediatrics, 2007, 120(2): 322-329.
[25]
Foglia EE, Owen LS, Thio M, et al. Sustained Aeration of Infant Lungs (SAIL) trial: study protocol for a randomized controlled trial [J]. Trials, 2015, 16: 95.
[26]
Abd El-Fattah N, Nasef N, Al-Harrass MF, et al. Sustained lung inflation at birth for preterm infants at risk of respiratory distress syndrome: The proper pressure and duration [J]. J Neonatal Perinatal Med, 2017, 10(4): 409-417.
[27]
McGrory L, Owen LS, Thio M, et al. A randomized trial of conditioned or unconditioned gases for stabilizing preterm infants at birth [J]. J Pediatr, 2018, 193(2): 47-53.
[28]
Committee on Fetus and Newborn; American Academy of Pediatrics. Respiratory support in preterm infants at birth [J]. Pediatrics, 2014, 133(1): 171-174.
[29]
徐芬,罗俊,黎红平,等. LISA技术治疗新生儿呼吸窘迫综合征有效性的系统评价 [J]. 临床儿科杂志,2017, 35(3): 223-228.
[30]
Klebermass-Schrehof K, Wald M, Schwindt J, et al. Less invasive surfactant administration in extremely preterm infants: impact on mortality and morbidity [J]. Neonatology, 2013, 103(4): 252-258.
[31]
Göpel W, Kribs A, Härtel C, et al. Less invasive surfactant administration is associated with improved pulmonary outcomes in spontaneously breathing preterm infants [J]. Acta Paediatr, 2015, 104(3): 241-246.
[32]
Cummings JJ, Polin RA, Committee on Fetus and Newborn, American Academy of Pediatrics. Noninvasive respiratory support [J]. Pediatrics, 2016, 137(1): e20153758.
[33]
Lemyre B, Laughon M, Bose C, et al. Early nasal intermittent positive pressure ventilation (NIPPV) versus early nasal continuous positive airway pressure (NCPAP) for preterm infants [J]. Cochrane Database Syst Rev, 2016, (12): CD005384.
[34]
Roberts CT, Owen LS, Manley BJ, et al. Nasal high-flow therapy for primary respiratory support in preterm infants[J]. N Engl J Med, 2016, 375(12): 1142-1151.
[35]
Lavizzari A, Colnaghi M, Ciuffini F, et al. Heated, humidified high-flow nasal cannula vs nasal continuous positive airway pressure for respiratory distress syndrome of prematurity: arandomized clinical noninferiority trial[J]. JAMA Pediatr, 2016, 170(12): 1228.
[1] 李志文, 李远志, 李华, 方志远. 糖皮质激素治疗膝骨关节炎疗效的网状Meta分析[J]. 中华关节外科杂志(电子版), 2024, 18(04): 484-496.
[2] 戴瑞芝, 霍美池, 李峥. 无创高频振荡通气对早产儿呼吸窘迫综合征的临床疗效[J]. 中华危重症医学杂志(电子版), 2022, 15(05): 372-378.
[3] 郭立珍, 范天群, 张欣凯, 蒋韵红, 金蓉, 刘冬云. 早产小于胎龄儿发生支气管肺发育不良的危险因素及预后分析[J]. 中华妇幼临床医学杂志(电子版), 2024, 20(02): 209-215.
[4] 田权秀, 韩爱民, 徐艳. 动脉导管未闭与极低出生体重早产儿支气管肺发育不良的相关性分析[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(06): 675-682.
[5] 杨皓媛, 龚杰, 邹青伟, 阮航. 哮喘孕妇的母婴不良妊娠结局研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(05): 522-529.
[6] 胡诤贇, 史建伟, 申建伟, 王冰, 蒋春苗, 刘冲. 基于机器学习鉴定早产儿支气管肺发育不良的关键基因[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(04): 446-454.
[7] 李敏, 熊菲. 母乳成分及其影响因素的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 267-272.
[8] 周美岑, 王华, 母得志. 早产儿疫苗预防接种及时性[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(03): 261-266.
[9] 杨萍, 许世敏, 李亮亮, 尹向云, 锡洪敏, 马丽丽, 李向红. 早产儿支气管肺发育不良合并代谢性骨病的影响因素[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 202-211.
[10] 苏永维, 陈果. 早产儿非心脏手术的麻醉管理[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(02): 139-144.
[11] 张霭润, 招嘉樑, 李管明, 李嘉鸿, 陈静蓉, 王兰, 庄思齐, 房晓祎. 早产儿RhE合并Rhc溶血病1例并文献复习[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 93-99.
[12] 张璐, 杨惠娟, 刘凯波. 2015—2021年北京市辅助生殖技术助孕活产及高龄孕母占比与不良妊娠结局变化趋势[J]. 中华妇幼临床医学杂志(电子版), 2023, 19(01): 46-53.
[13] 袁冰, 颜凯. 人羊膜上皮干细胞治疗早产儿支气管肺发育不良的研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(06): 640-644.
[14] 伏洪玲, 刘瀚旻. 支气管肺发育不良及肺动脉高压有关信号通路研究现状[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(05): 497-505.
[15] 强光峰, 孟兰兰, 赵静, 牛峰海, 任雪云. 肺部超声评分对呼吸困难新生儿使用有创机械通气的预测价值[J]. 中华诊断学电子杂志, 2023, 11(02): 104-108.
阅读次数
全文


摘要