胎便吸入症候群嬰兒於2歲時神經發展之預後

Neurodevelopment Outcome of Meconium Aspiration Syndrome at 2 Years of Age

林鴻志(Hung-Chih Lin) ； 蘇百弘(Bai-Horng Su) ； 林宗文(Tsung-Wen Lin) ； 蔡長海(Chang-Hai Tsai)

《Mid-Taiwan Journal of Medicine》 8卷s_2期 (2003/12) Pp. s79-s84

https://doi.org/10.6558/MTJM.2003.8(s_2).2

摘要

Objectives: Few published papers have discussed the long-term neurodevelopment outcome of MAS. The aim of this prospective study was to investigate the neurodevelopment of neonate with MAS at 2 years of age.
Methods: From 1995 to 2003, a prospective clinical study was conducted at the high risk follow up clinic. MAS was diagnosed by the presence of meconium below the vocal cord, accompanied by respiratory distress with tachypnea, retraction, cyanosis and an abnormal chest X-ray finding. Patients with cyanotic heart disease or fetal congenital malformations were excluded. Asphyxia, pneumothorax, pulmonary hemorrhage, PPHN, bronchopulmonary dysplasia were diagnosed by a neonatologist. Oxygen, nasal continuous positive airway pressure (CPAP), and conventional mechanical ventilation, surfactant, HFO, INO decadron were applied as clinically indicated. Neurodevelopment assesment was evaluated by GMS, the baley test and infant crib.
Results: There were 327 cases of MAS during 7 years;312 infants survived, and 285 infants completed the follow up program at 2 years of age. Seven infants had chronic sejiure, 3 infants had mild neurodevelopment delay, 7 infants had moderate neurodevelopment delay, and 5 infants had sever neurodevelopment delay. Univarient analysis revealed asphyxia, shock, and neonatal seizure. High frequency ventilation, surfactant and days of ventilation were the risk factors for moderate to severe neurodevelopment delay.
Conclusions: We conclude that few of the cases had neurological sequela. Unless it is associated with hypoxia or ischemia, MAS alone does not increase the risk of neurodevelopement sequela in neonates with MAS.

關鍵字

神經發展 ； 窒息 ； 胎便吸入症候群 ； 休克

並列摘要

Objectives: Few published papers have discussed the long-term neurodevelopment outcome of MAS. The aim of this prospective study was to investigate the neurodevelopment of neonate with MAS at 2 years of age.
Methods: From 1995 to 2003, a prospective clinical study was conducted at the high risk follow up clinic. MAS was diagnosed by the presence of meconium below the vocal cord, accompanied by respiratory distress with tachypnea, retraction, cyanosis and an abnormal chest X-ray finding. Patients with cyanotic heart disease or fetal congenital malformations were excluded. Asphyxia, pneumothorax, pulmonary hemorrhage, PPHN, bronchopulmonary dysplasia were diagnosed by a neonatologist. Oxygen, nasal continuous positive airway pressure (CPAP), and conventional mechanical ventilation, surfactant, HFO, INO decadron were applied as clinically indicated. Neurodevelopment assesment was evaluated by GMS, the baley test and infant crib.
Results: There were 327 cases of MAS during 7 years;312 infants survived, and 285 infants completed the follow up program at 2 years of age. Seven infants had chronic sejiure, 3 infants had mild neurodevelopment delay, 7 infants had moderate neurodevelopment delay, and 5 infants had sever neurodevelopment delay. Univarient analysis revealed asphyxia, shock, and neonatal seizure. High frequency ventilation, surfactant and days of ventilation were the risk factors for moderate to severe neurodevelopment delay.
Conclusions: We conclude that few of the cases had neurological sequela. Unless it is associated with hypoxia or ischemia, MAS alone does not increase the risk of neurodevelopement sequela in neonates with MAS.

並列關鍵字

asphyxia ； meconium aspiration syndrome ； neurodevelopement ； shock