西宁地区新生儿肺出血164例临床分析

Neonatal Pulmonary Haemorrhage in Xi'ning Area: An analysis of 164 cases

目的:探讨西宁地区(2260m)新生儿肺出血高危因素及早期治疗措施,进一步提高抢救成活率。方法:对我科确诊的164例新生儿肺出血从发病日龄、临床表现、X线检查、血气分析、治疗方法进行分析。结果:70.73%为早产儿,78.66%为低体重儿,44.51%有低体温,48.17%有窒息史及缺氧因素,51.83%原发病有感染因素。164例中采用机械通气者68例,96例未用机械通气,机械通气者成活率明显高于未用机械通气者,P<0.001,两组有显著差别。结论:高海拔地区围产期窒息缺氧、寒冷、早产、低体重、严重感染是引起肺出血的高危因素,早期诊断及时行气管插管,使用机械通气,加强综合治疗和呼吸道管理可明显降低肺出血的死亡率。

Objective：To estimate the high risk factors of neonatal pulmonary haemorrhage, and treatment effects in Xining areas （2 260m） to profoundly augment the survival. Methods：The documents of 164 newborns that were confirmed to have pulmonary haemorrhage in our department were reviewed on the basis of age, clinical manifestations, X--ray examination, blood gas and treatment. Results： 70. 73% pulmonary haemorrhage of 164 cases showed in the premature infants, 78. 66% in low birth weight children, 44.51% in low body temperature; 48. 17% have hypoxia and asphyxia; 51.83% have infection of primary disease. Duration of treatment, 68 of 164 cases received the mechanical ventilation but remainders did not use, and there was a significant difference between both section （P〈0. 001）. Conclusions：The perinatal asphyxia, hypoxia, cold, premature, low birth weight and serious pulmonary infection cause neonatal pulmonary haemorrhage as result of these high risk factors. Early diagnosis and use of mechanical ventilation will contribute to treatment of neonatal pulmonary haemorrhage in Xi＇ning.