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Objective To explore the pathogenesis of acute respiratory distress syndrome (ARDS) in fullterm newborns, and to assess the effect of pulmonary surfactant. Methods All full-term newboms were divided into two groups,with 50 cases in group A and 12 cases in group B. Compared to the treatment of group A,pulmonary surfactant was added to group B. The indicators of pH, PaO2, PaCO2, SaO2, HCO3- were compared between the two groups.Results The cure rate was 92% in group B , which was significant higher than that of 80% in group A( t = 3. 5,P < 0. 05 ). There were 42 cases of neonatal asphyxia (68%), 36 cases of asphyxia combined aspiration pneumonia (58% ) ,19 cases of cesarean section(31% ) ,6 cases of milk aspiration pneumonia (10% ) and 3 cases of infectious pneumonia (5 % ). The AUC was 0. 80,0. 76,0. 35,0. 83 and 0.74, respectively.Neonatal asphyxia, asphyxia combined aspiration pneumonia,milk aspiration pneumonia and infectious pneumonia were associated with ARDS in full-term newborns. PaO2 in group A and B was (78. 80 ± 8. 2 ) mm Hg and (87. 20 ± 8. 30) mm Hg, respectively (t = 4. 56, P < 0. 05 ). SaO2 in group A was (89. 50 ± 5.40) % ,which was significantly lower than that of (99. 63 ± 3. 30 ) % in group B (t = 5. 78, P < 0. 05). Conclusions There are various causes of ARDS in full-term newborns.Intensive clinical observation and continuous monitoring of blood oxygen saturation will be helpful to improve the efficiency of treatment Pulmonary surfactants can improve the efficiency in the treatment of ARDS in the full-term newboms.
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Objective To study the clinical factors of sclerema neonatorum complicated with pneumorrhagia and propose therapy and control measures in order to.improve clinical treatment.Methods27 cases of sclerema neonatorum complicated with pneumorrhagia treated in Chaozhou Central Hospital from January 2005 to December 2007 were investigated retrospectively.Results In all 96 cases of sclerema neonatorum,27 Were complicated with pneumorrhagia.mortality of which was 67%.9 cases of pneumorrhagia without mechanical ventilation died totally.Early tracheal intubation discovered 9 cases of pneumorrhagia,mortality was 56%.5 cases died within the 6 oronasal emissing blood,taking up 83%in mortality.There were significant differences between them(P＜0.05).Conclusion The incidence of pneumorrhagia in sclerema neonatorum was closely related to fetal month,age,scleredema degrees,acidosis,birth weight ect.The more severe scleredema,the lower birth weight and the fewer fetal month were,the higher incidence rate was.
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OBJECTIVE To investigate the pathogen spectrum distribution in respiratory tract infection during the past twelve years.METHODS The method was retrospectively analyzed.RESULTS A total of 7596 strains in(clinical) specimens were isolated.It showed that the isolating rate of Gram positive cocci,Gram negative bacilli and fungis was 34.56%,48.62% and 10.10%,respectively.The isolating rate of Gram positive cocci was 25.96% between Jan 1991 to Dec 1996,the most commonly isolated bacteria of which were Staphylococcus(aureus),Streptococcus pneumoniae and ?-hemolytic streptococci,with isolating rates being 6.85%,4.84 % and(4.26%),(respectively);the isolating rate of Gram negative bacilli was 63.33%,the most commonly isolated bacteria of which were Pseudomonas aeruginosa,Escherichia coli and Klebsiella pneumoniae,with isolating rates being(8.46%),7.97% and 7.09%.The isolating rate of Gram positive cocci was 37.91% between Jan 1997 to Dec 2002,the most commonly isolated bacteria of which were S.aureus,?-hemolytic streptococci and Str.pneumoniae,with isolating rates being 10.28%,7.02% and 6.68%,respectively;the isolating rate of Gram negative bacilli was 47.64%,the most commonly isolated bacteria of which were P.(aeruginosa),E.coli and K.pneumoniae,with isolating rates being 8.19%,7.07% and 5.21%,respectively.The isolating rate of fungi was 6.06% and 11.43%,respectively during the two stages,the most commonly pathogen of which was Candida albicans.(CONCLUSIONS) The pathogen spectrum distribution in respiratory tract infection during the past twelve years has changed significantly.The isolating rate of Gram positive cocci and fungi,respectively is gradually increasing,but that of Gram negative bacilli is decreasing.