早期无创呼吸支持结合暂时性气管插管PS应用治疗新生儿呼吸窘迫综合征失败的高危因素分析被引量：27

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摘要目的：分析INSURE联合n CPAP或Bi PAP作为新生儿呼吸窘迫综合征初始治疗失败的危险因素。方法：选择2011年1月至2015年10月我院出生,诊断新生儿呼吸窘迫综合征并给予INSURE治疗的早产儿120例。2013年1月前入选的早产儿初始呼吸策略为INSURE＋n CPAP,其后为INSURE＋n CPAP/Bi PAP。按疗效分为INSURE失败组和INSURE成功组。对所有入选早产儿的临床资料进行回顾性分析。结果：INSURE成功组为86例（71.67%）,失败组为34例（28.33%）。失败组在胎龄、出生体重、经阴道分娩、产前激素应用、动脉肺泡氧分压比值（arterial/alveolar oxygen tension ratio,a/APO2）均低于成功组（P〈0.05）;动脉血二氧化碳分压（Pa CO2）则明显高于成功组（P〈0.05）。Logistic回归分析显示胎龄〈32周（OR=2.41、95%CI=0.98~8.45）,出生体重〈1 500 g（OR=2.38、95%CI=0.55~11.51）,Pa CO_2〉7 k Pa（OR=5.35、95%CI=2.08~11.01）,a/APO_2〈0.44（OR=2.83、95%CI=1.24~6.48）均是INSURE治疗失败的独立危险因素。结论：INSURE治疗失败的独立危险因素包括：胎龄〈32周、出生体重〈1 500 g、Pa CO2〉7k Pa及动脉肺泡氧分压比值〈0.44。

作者赵小朋吕回陆琰张庭艳沈婷孙黎

机构地区广州市妇女儿童医疗中心新生儿科

出处《实用医学杂志》 CAS 北大核心 2016年第18期3093-3095,共3页 The Journal of Practical Medicine

关键词呼吸窘迫综合征无创呼吸支持 INSURE治疗危险因素

分类号 R722.1 [医药卫生—儿科]

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