摘要
目的评估极早产儿无创通气(non-invasive ventilation,NIV)失败的发生率,并确定其预测因素和不良结局。方法选取2019年6月~2021年9月哈尔滨医科大学附属第一医院新生儿重症监护病房收治的215例胎龄<32周早产儿,根据NIV的结局分为无创失败组(29例)和无创成功组(186例)。采用Logistic回归分析法分析NIV失败的独立预测因素及不良结局。结果NIV失败率为13.5%(29/215)。研究发现较小胎龄、出生后1分钟及5分钟Apgar评分<7分、呼吸窘迫综合征(respiratory distress syndrome,RDS)≥Ⅲ级、吸入氧浓度(fraction of inspired oxygen,FiO_(2))>0.30是NIV失败的独立预测因素(P<0.05),NIV失败与不良结局相关,包括死亡率、中重度支气管肺发育不良(broncho pulmonary dysplasia,BPD)、新生儿肺出血、重度脑室内出血(intraventricular hemorrhage,IVH)和早产儿视网膜病(retinopathy of prematurity,ROP)≥2期(P<0.05)。结论NIV失败可以通过胎龄较小、出生后1分钟及5分钟Apgar评分<7分、RDS≥Ⅲ级以及FiO_(2)>0.30来预测。这种NIV失败与临床不良结局相关。
Objective To analyze the rates of failure of non-invasive ventilation(NIV)in very preterm infants,and to identify the predictors and adverse outcomes.Methods A total of 215 preterm infants with gestational age<32 weeks admitted to the Neonatal Intensive Care Unit of Qunli District of the First Affiliated Hospital of Harbin Medical University from June 2019 to September 2021 were selected and divided into non-invasive failure group(29 cases)and non-invasive success group(186 cases)according to the outcome of NIV.Logistic regression analysis was used to analyze the independent predictors and adverse outcomes of NIV failure.Results The incidence of NIV failure was 13.5%(29/215).Smaller gestational age,Apgar score<7 at 1 minute and 5 minutes,respiratory distress syndrome(RDS)≥Ⅲgrade and fraction of inspired oxygen(FiO_(2))>0.30 represented independent predictors for NIV failure(P<0.05).It was associated with adverse outcomes,including mortality,moderate or severe broncho pulmonary dysplasia(BPD),neonatal pulmonary hemorrhage,severe intraventricular hemorrhage(IVH),and retinopathy of prematurity(ROP)≥stage 2(P<0.05).Conclusion NIV failure could be predicted by smaller gestational age,Apgar score<7 at 1 minute and 5 minutes,RDS≥Ⅲgrade and FiO_(2)>0.30.This NIV failure is associated with clinical adverse outcomes.
作者
房冰
付中秋
FANG Bing;FU Zhong-qiu(Department of Neonatology,The First Affiliated Hospital of Harbin Medical University,Harbin 150077,China)
出处
《哈尔滨医科大学学报》
CAS
2022年第6期557-561,共5页
Journal of Harbin Medical University
基金
国家自然科学基金资助项目(81501290)
关键词
早产儿
无创通气
预测因素
不良结局
preterm infants
noninvasive ventilation
predictors
adverse outcomes
