早产儿发生呼吸暂停相关因素分析

Analysis on the related factors about apnea of premature infants

目的分析早产儿发生呼吸暂停的高危因素,指导临床防治工作。方法收集2007年3月至2010年8月收治并诊断为早产儿呼吸暂停的85例患儿资料作为实验组,将同期入院的未发生呼吸暂停的早产儿85例作为对照组,统计两组胎儿胎龄的分布,对首次发生呼吸暂停的日龄与病因进行统计分析,对引起呼吸暂停相关因素进行单因素统计分析。结果实验组小于30周胎龄的早产儿占75.8%,而对照组仅占24.2%。胎龄在34～37周的患儿中,对照组所占比例高于实验组。小于30周胎龄发生原发性呼吸暂停的占78.9%,而30～34周胎龄发生原发性呼吸暂停的占25.6%。继发性呼吸暂停主要发生在30～34周胎龄的患儿中,约占74.4%。胎儿日龄在1d之内的患儿发生继发性呼吸暂停的比例为52.6%,而原发性呼吸暂停主要发生在日龄在2～7d的患儿中约占67.9%。相关因素单因素分析结果显示早产儿脑损伤、新生儿贫血、酸中毒、低血纳、新生儿肺炎、新生儿肺透明膜病在实验组和对照组中的差异具有统计学意义(P<0.05)。结论呼吸暂停与胎龄、胎儿体重、早产儿脑损伤、新生儿贫血、酸中毒、低血纳、新生儿肺炎、新生儿肺透明膜病等多因素有关。对这些高危因素的早期干预与治疗有助于降低呼吸暂停的发生率。

Objective To analyze the related factors about apnea of premature infants,and provide guidance for clinical practice.Methods 85 cases premature infants with apnea hospitalized in the 202th Hospital of PLA from Mar.2007 to Aug.2010 were enrolled as the study group.85 premature infants not diagnosed with apnea were enrolled as the control group.The gestational age,daily age and correlative factor of apnea were analyzed.Results In the study group,premature infant with gestational age below 30 weeks makes up 75.8%,while that in the control group makes up 24.2%.The proportion of infants with gestational age of 34~37 weeks was high in the control group than the study group.The incidence of primary apnea was 78.9% for the infants with gestational age below 30 weeks,and 25.6% for the infants with gestational age of 34~37 weeks.Secondary apnea mainly occurred in infants with gestational age of 30~34 weeks and the incidence of secondary apnea for infants with daily age of 1 d was 52.6%.Primary apnea mainly occurred in infants with daily age of 2~7 days,accounting for 67.9%.Brain damage,pneumonia,acidosis,hyponatremia,neonatal hyaline membrane disease showed statistically significant difference between the two groups（P0.05）.Conclusion Apnea was related with gestational age,birth weight,brain damage,hyponatremia,acidosis,neonatal hyaline membrane disease,and pneumonia.Early intervention and treatment of the above risk factors would reduce the incidence of apnea.