NICU新生儿多脏器功能损害与出生时状况相关因素分析

Clinical Study on Risk Neonate Multiple Organ Dysfunction and Its Relationship with Birth Status

目的探讨高危新生儿多脏器功能损害(Multiple organ dysfunction,MODS)发生率与出生时状况的相关性,以早期诊断并及时给予干预和治疗,改善预后。方法将NICU2009年1月—2010年1月收治危重新生儿脏器损害数目≥2个的诊断为新生儿MODS;按出生时不同状况:胎龄、出生体重、有无宫内窘迫或窒息MODS发生率,各组间MODS发生率的比较采用计数资料χ2检验,P<0.05为有统计学意义;MODS发生率与胎龄及出生体重的相关性用统计学直线相关分析法,P<0.05为有统计学意义。结果新生儿MODS 199例,早产儿175例,占本组MODS的87.9%,明显高于足月儿,早产儿与足月儿MODS发生率比较差异显著,有统计学意义(χ2=17.866,P<0.05);在不同胎龄MODS发生率的比较中,低出生体重儿169例占本组84.9%,低出生体重儿及正常出生体重儿MODS发生率比较差异显著(χ2=19.215,P<0.05);出生体重及胎龄与发病率相关性分析结果呈负相关(r=-0.9356,r=-0.7918,P<0.05);有窒息史(包括宫内窘迫)新生儿MODS发生率为70.6%,与无窒息组发生率比较差异显著,有统计学意义(χ2=1.502E2,P<0.05)。结论早产、低出生体重、窒息是导致新生儿MODS主要原因;新生儿MODS发生率与胎龄及出生体重呈负相关。

Objective To explore the high-risk neonates with multiple organ dysfunction（multiple organ dysfunction,MODS） incidence of birth-related conditions,so as to provide early diagnosis and timely intervention and treatment,improve prognosis.Methods The NICU organ damage in critically ill neonates from Jan,2009-Jan,2010 admitted to the number ≥2 flats in the diagnosis of neonatal MODS;according to different conditions at birth： gestational age,birth weight,with or without fetal distress or asphyxia MODS incidence of MODS in each group was used to compare the incidence of count data χ2 test,P0.05 as statistically significant;MODS incidence of birth weight and gestational age,and the correlation with statistical linear correlation analysis,P0.05 to have statistical significance.Results Neonatal MODS 199 cases,175 cases of premature infants MODS in this group accounted for 87.9%,significantly higher than full-term infants,premature infants and full-term infants the incidence of MODS were significant differences statistically significant（χ2=17.866,P0.05）;In different gestational age,the incidence of MODS comparison,169 cases of infants with low birth weight accounted for 84.9% in this group,low birth weight infants and normal birth weight infants the incidence of MODS was significant difference（χ2=19.215,P0.05）,birth weight and gestational age and the incidence of rate-dependent analysis of the results of a negative correlation（r=-0.9356,r=-0.7918,P0.05）;A asphyxia history（including fetal distress） neonatal MODS incidence was 70.6%,and non-asphyxia group compared the incidence of significant difference,statistically significant（χ2=1.502E2,P0.05）.Conclusion Premature birth,low birth weight,asphyxia is the main cause of neonatal MODS;MODS incidence of neonatal gestational age and birth weight were negatively correlated.