摘要目的 通过对深圳地区城市医院新生儿呼吸窘迫综合征(RDS)临床资料的收集与分析,探讨深圳地区RDS的发病特点、救治现状和结局.方法 采用分层整群抽样的方法抽取8家深圳市二、三级综合医院和专科医院为调查单位,前瞻性地收集2010年8月1日至2011年7月31日产科分娩婴儿和RDS患儿的临床资料.结果 深圳地区新生活产婴儿34 572例,患RDS 462例,RDS发病率为1.34％；其中男298例,女164例,男∶女=1.82∶1.00；早产儿425例(占91.99％)；＜28周、28～31+6周、32 ～ 33+6周、34～36+6周、37～38+6周、39～42周、＞42周新生儿RDS发生率依次为55.17％、45.36％、21.91％、5.79％、0.21％、0.08％、0；约70.00％的RDS患者接受肺表面活性物质替代治疗,主要通气方式为经鼻持续呼吸道正压通气,约占85.06％,通气时间(68.44±37.43) h;51.73％的患儿接受气管插管-表面活性物质-拔管使用经鼻持续呼吸道正压通气(INSURE)技术的治疗,好转治愈率为88.31％,院内病死率为1.95％.住院时间为(20.28±16.04)d,人均住院费用为30 342.23元.结论 深圳地区新生儿RDS的发病率为1.34％；INSURE技术是目前深圳地区RDS主要治疗措施,好转治愈率为88.31％,并发症以感染为首位,该病住院时间长,人均花费大.

abstractsObjective To investigate the incidence,management and outcome of neonatal respiratory distress syndrome (RDS) in Shenzhen area.Methods The stratified cluster sampling method was used to extract 8 hospitals in Shenzhen area,including Ⅱ or Ⅲ level hospitals and specialized hospitals for the investigation unit,the clinical data of infants with RDS and obstetric delivery live infants in Aug.1,2010 to Jul.31,2011 were prospectively collected.Results There were 34 572 live births in these hospitals and 462(1.34％) newborns had RDS.Among the infants with RDS,64.5％ were male and 91.99％ were premature infants.The incidence of RDS was 55.17％ during ＜ 28 weeks gestation newborns,45.36％ during 28 weeks to 31 weeks and 6 days gestation newborns,21.91％ during 32 weeks to 33 weeks and 6 days gestation newborns,5.79％ during 34 weeks to 36 weeks and 6 days gestation newborns,0.21％ during 37 weeks to 38 weeks and 6 days gestation newborns,0.08％ during 39-42 weeks gestation newborns,and 0 during ＞ 42 weeks gestation newborns.Nearly 70.00％ infants with RDS received surfactant treatment,and 85.06％ infants with RDS were treated by nasal continuous positive airway pressure (nCPAP).The average time of nCPAP was (68.44 ± 37.43) hours.The 51.73％ of children received INSURE (intubation-surfactant-extubation) technology.The survival rate was 88.31％,the mortality rate until discharge was 1.95 ％,the average length of hospitalization was (20.28 ± 16.04) days,and the average costs of hospitalization was 30 342.23 Yuan.Conclusions The morbidity of RDS in the Shenzhen was 1.34％.INSURE technology is the main treatment of RDS in the Shenzhen region.The survival rate was 88.31％,infections was the main complication of RDS.The longer the hospital stay,the higher the cost.