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《Chinese Journal of Practical Pediatrics》 2003-01
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Multiple risk factors analysis of episode and prognosis of neonatal hyaline membrane disease

Yu Jialin, Liu Gang,Hu Fayuan.Dept of Neonatology, Children’s Hospital, Chongqing University of Medical Sciences, Chongqing 400014,China  
Objective To search the risk factors of episode and prognosis of neonatal hyaline membrane disease.Methods One hundred and one cases of neonatal hyaline membrane disease (HMD) in our ward from July 1994 to August 2000 were analysed , with control of 111 cases having no HMD were retrospectively analys ed.Results HMD was more common in males than in females.The predisposing factors included placental abruption, cesarean section and fetal distress. Antepartum use of glucocorticoid could prevent episode of HMD. The negative rate of bubble shake test taken from the sample of gastric juice was 82 1% (55/67), which was significantly higher than the control. Of 101 HMD infants, 95(94 1%)presented symptoms within 6 hours after birth, among whom 39 cases presented onset of illness immediately after birth. Cure rate of the HMD group was 52 2%,while the control was 89 0%,χ 2=29 89,P 0 01 Mortality of HMD was 41 8%,while the control was 0,χ 2=54 17,P0 01. Apgar score was significantly lower in death group than the cure group of HMD. Of grade Ⅳ lesion in chest X-ray,Mortality was 38 7%(13/22),with only 25%(10/40) in Ⅰ、Ⅱ、Ⅲ grade of the lesion together,χ 2=7 07,P0 01 56 7% of the patients who presented symptoms just after being born died, however,only 29 7% of the patients who presented episode during some incubation period was dead,χ 2=4 94,P0 05 There was negative correlation(r = - 0 970,P0 05)between gestational age and mortality. The death rate of neonates with HMD complicated with pulmonary hemorrhage or IVH was statistically higher than those without bleeding.Conclusions Suspicious risk factors of HMD should be avoided and glucocorticoid should be used before delivery in order to reduce the incidence of HMD. It can decrease mortalily to actively treat those complications of HMD which easily lead to death.
【CateGory Index】: R722.1
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