摘要
目的探讨围生期病理因素对新生儿持续肺动脉高压(Persistent Pulmonary Hypertension,PPHN)发病的影响。方法对新生儿重症监护病房收治的41例PPHN患儿临床资料进行回顾性分析,并随机抽取同期收治的44例非新生儿持续肺动脉高压(non-Persistent Pulmonary Hypertension,non-PPHN)的患儿作为对照组,对PPHN发病的相关危险因素进行单因素χ2分析及多因素Logistic回归分析。结果单因素分析提示:观察组和对照组在Apgar评分、剖腹产、宫内窘迫、氧分压、Ⅱ型呼吸衰竭、BE值、气胸、肺炎、接受机械通气方面存在统计学意义(P<0.05);Logistic回归分析提示宫内窘迫、机械通气、剖腹产、Ⅱ型呼吸衰竭为PPHN的独立危险因素(P<0.001,OR值为2.75、14.574、4.024、1.051),高Apgar评分、高氧分压、BE值正常为PPHN的保护因素(P<0.001,OR值为0.751、0.893、0.958)。结论PPHN是一种多因素相关的疾病,剖腹产、宫内窘迫、Ⅱ型呼吸衰竭、机械通气是PPHN的危险因素,减少围生期的不良因素,积极纠正出生后的代谢紊乱,避免过高的胸腔内压力,控制感染,是提高PPHN患儿救治率的关键。
Objective To explore the influence of perinatal pathologic factors on the incidence of persistent pulmonary hypertension( PPHN) in newborns. Methods The clinical data of 41 cases of PPHN in the neonatal intensive care unit were analyzed retrospectively,and 44 cases of non-persistent pulmonary hypertension( non-PPHN)were randomly selected as the control group. The single factor χ~2 analysis and multiple factor Logistic regression analysis were carried out. Results The single factor analysis indicated that the observation group and the control group had statistical significance in Apgar score,Caesarean section,intrauterine distress,oxygen partial pressure,type Ⅱ respiratory failure,BE value,pneumothorax,pneumonia,and mechanical ventilation( P < 0. 05). Logistic regression analysis suggested that intrauterine distress,mechanical ventilation,Caesarean section,and type Ⅱ respiratory failure were independent risk factors for PPHN( P < 0. 001,OR = 2. 75,14. 574,4. 024,1. 051). High Apgar score,high oxygen partial pressure,and normal BE value were PPHN protection factors( P < 0. 001,OR = 0. 751,0. 893,0. 958). Conclusion PPHN is a multi-risk disease. Caesarean section,intrauterine distress,type Ⅱ respiratory failure,and mechanical ventilation are the high-risk factors of PPHN. It is the key to improve the recovery rate of children with PPHN by reducing the adverse factors during perinatal period,actively intervening to correct metabolic disorders after birth,avoiding excessive intrapleural pressure,and controlling infection.
作者
刘学丹
周浩泉
李晓春
LIU Xue-dan;ZHOU Hao-quan;LI Xiao-chun(The First Affiliated Hospital of USTC,Division of Life Sciences and Medicine,University of Science and Technology of China,Anhui 230000,China)
出处
《临床肺科杂志》
2020年第10期1511-1514,共4页
Journal of Clinical Pulmonary Medicine
基金
安徽省科技厅重点研究与发展计划项目(No.1804e03020323)。
关键词
新生儿
持续肺动脉高压
危险因素
newborn
persistent pulmonary hypertension
risk factors
