ارزشیابی تست تکانه آسپیراسیون معده در پیشگویی نیاز به سورفکتانت در نوزادان با سن حاملگی کمتر مساوی 34 هفته مبتلا به بیماری غشاء هیالین

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار طب نوزادی و پیرامون تولد، گروه کودکان، دانشکده پزشکی، بیمارستان امیرالمومنین، دانشگاه علوم پزشکی زابل، زابل، ایران

2 متخصص کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل، ایران

3 عضو هیات علمی ، گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی زابل، زابل، ایران

چکیده

چکیده
مقدمه: بیماری غشاء هیالین[1] (HMD) از شایع‌ترین بیماری‌های تنفسی در نوزادان نارس است. علت اصلی بیماری کمبود سورفکتانت بوده و علائم بالینی آن شامل تاکی پنه، دیسترس تنفسی، سیانوز، گرانتینگ و افزایش نیاز به اکسیژن است. به طور کلی دو روش برای تجویز سورفکتانت وجود دارد، 1-پروفیلاکتیک 2- درمانی (Rescue). هدف مطالعه حاضر تاثیر تست تکانه آسپیراسیون معده در پیشگویی نیاز به سورفکتانت در نوزادان است.
روش کار: مطالعه حاضر به صورت توصیفی تحلیلی بوده که در آن کلیه نوزادان تازه متولد شده با سن حاملگی کمتر یا مساوی 34 هفته که دیسترس تنفسی داشتند و علائم بالینی بیماری غشا هیالین مانند گرانتیک، سیانوز، رتراکشن بین دنده ای و زیر دنده ای داشته اند مورد مطالعه قرار گرفتند و علل غیر از موارد ذکر شده جزء معیار خروج بوده و از مطالعه خارج شدند. روش نمونه گیری به کار رفته آسان بوده و اطلاعات از طریق مصاحبه ،بررسی اسناد   جمع آوری گردید. سپس دادها وارد نرم افزار SPSS v21 شد و به منظور تجزیه تحلیل داده ها و از آمارهای توصیفی و آزمون رگرسیون برای تعیین نسبت شانس استفاده شد.
نتایج: در مطالعه حاضر 91 نوزاد شرکت داشتند که 62 (68.1%) نوزاد پسر و 29 (31.9%) نوزاد دختر بوده اند. میانگین وزنی نوزادان در هنگام تولد 593±1662 گرم و میانگین سنی آن‌ها 2.5±31.7 هفته بود. میزان زایمان های طبیعی و سزارین صورت گرفته در این مطالعه به ترتیب 35(38.5%) و 56(61.5%) است. در این مطالعه دیابت، فشارخون، اعتیاد، تجویز کوتیکواستروئید و جنسیت رابطه معنی‌داری با بیماری غشاءهیالین داشتند (P<0.05). برطبق مطالعه حاضر نوع زایمان صورت گرفته با بیماری غشاء هیالین رابطه معنی‌داری نداشت (P>0.05).
بحث و نتیجه‌گیری: مطالعه ما نشان داد که فرزندان مادران مبتلا به فشارخون، اعتیاد و دیابت کمتر از سایرین به بیماری غشاءهیالین مبتلا شده و نیاز به تجویز سورفکتانت می باشند. همچنین تجویز داروهای کورتیکواستروئیدی به مادران نیز با بروز بیماری غشاء هیالین ارتباط دارد.



[1] Hyaline Membrane Disease

کلیدواژه‌ها

عنوان مقاله [English]

Gastric aspirate shake test for predicting of surfactant therapy in premature neonates with gestational age ≤ 34W with hyaline membrane disease

نویسندگان [English]

  • Mehran Hesaraki 1
  • Seyedeh Mahtab Mir ostovar Moghadam 2
  • Soleyman Saravani 3
1 Associate Professor of Neonatal-Perinatal Medicine,Department of Pediatrics, School of Medicine Amir al momenin Hospital,Zabol university of medical sciences,Zabol,Iran
2 Assistant Professor of Pediatrics,Department of Pediatrics, School of Medicine,Amir al momenin Hospital,Zabol university of medical sciences,Zabol,Iran
3 Instructor of Medical Education,Department of Community Medicine, School of Medicine Zabol university of medical sciences,Zabol,Iran
چکیده [English]

ABSTRACT
Introduction: Hyaline membrane disease (HMD) is one of the most common respiratory diseases in preterm infants. The main cause of the disease is surfactant deficiency and its clinical symptoms include respiratory distress tachypnea, cyanosis, granulation, and increased oxygen demand. There are generally two methods of administering surfactants, 1- prophylactic 2- Rescue. This study aimed to evaluate the effect of gastric aspiration impulse test on predicting the need for surfactant in neonates.
Materials and methods: This study was a descriptive-analytic study in which all newborn infants less than or equal to 34 weeks of age had respiratory distress and clinical symptoms of hyaline membrane disease such as granitic, cyanosis, intraretinal retraction. And sub-ribs were studied and causes other than those listed are exclusion criteria and excluded. The sampling method was easy and data were collected from an oral interview of pregnant mothers, checking the files and completing the questionnaire. Data analysis software was SPSS v21 and descriptive statistics and regression tests were used for odds ratios.
Result: In this study, 62 (68.1%) neonates were male and 29 (31.9%) were female. The mean birth weight of neonates was 1662±593 g and their mean age was 31.7±2.5 weeks. Normal delivery and cesarean section in this study were 35 (38.5%) and 56 (61.5%), respectively. According to the findings, diabetes mellitus had a significant relationship with hyaline membrane disease. Hypertension, addiction, corticosteroid administration, and gender were also significantly associated with membrane disease (P <0.05). According to the present study, there was no significant relationship between the type of delivery and hyaline membrane disease (P> 0.05).
Conclusion: Our study showed that the offspring of mothers with hypertension, addiction, and diabetes were less likely than others to have membrane disease and need to be given surfactants. The administration of corticosteroid drugs to mothers is also associated with the development of hyaline membrane disease.

کلیدواژه‌ها [English]

  • Hyaline Membrane Disease
  • Aspiration Shake Test
  • Gastric Discharge
  • Surfactant
  • Premature Infant

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مجله دانشکده پزشکی دانشگاه علوم پزشکی مشهد
دوره 63، شماره 1
فروردین و اردیبهشت 1399
صفحه 2138-2148

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