新生儿肺出血危险因素分析

Analysis of risk factors of neonatal pulmonary hemorrhage

目的探讨新生儿肺出血的危险因素。方法回顾性分析新生儿重症监护病房105例肺出血和100例无肺出血新生儿的临床资料,采用单因素χ2检验和多因素Logistic回归分析判定肺出血的危险因素。结果胎龄<34周、出生体重<1 500 g、母亲妊高征、前置胎盘、宫内窘迫、出生时重度窒息、严重酸中毒、严重低氧血症、吸入高浓度氧、肺透明膜病、动脉导管未闭与肺出血的发生有关(P<0.05或P<0.01)。Logistic回归分析发现胎龄<34周、出生体重<1 500 g、严重酸中毒、严重低氧血症、肺透明膜病、动脉导管未闭为肺出血的独立危险因素(OR=9.665、12.403、1.559、3.221、1.825、1.664,P<0.05或P<0.01)。结论胎龄<34周、出生体重<1 500 g、严重酸中毒、严重低氧血症、肺透明膜病、动脉导管未闭是新生儿肺出血的重要危险因素,应重视并针对危险因素加以预防。

Objective To assess the risk factors of neonatal pulmonary hemorrhage. Methods The clinical datas of 105 cases with pulmonary hemorrhage and 100 cases without pulmonary hemorrhage in NICU were retrospectively analysed. Potential risk factours of neonatal pulmonary hemorrhage were studied by univariate analysis and Logistic regression analysis. Results Univariate analysis revealed that the gestational age 〈34 weeks, birth weight 〈1 500 g, mother with pregnancy induced hypertension syndrome, placenta previa, intrauterine distress, severe asphyxia at birth, severe acio- dosis, severe hypoxemia,inhalation of high concentration of oxygen,hyaline membrane disease, patent ductus arteriosus were associated with neonatal pulmonary hemorrhage （P 〈 0.05 or P 〈 0.01 ）. Logistic regression analysis revealed that the gestational age 〈34 weeks, birth weight 〈1 500 g, severe aciodosis,severe hypoxemia, hyaline membrane dis ease, patent ductus arteriosus were independent risk factors of neonatal pulmonary hemorrhage （OR = 9.665, 12.403, 1.559, 3.221, 1.825, 1.664, P 〈 0.05 or P 〈 0.01）. Conclusion The gestational age 〈34 weeks, birth weight 〈1 500 g, severe aciodosis, severe hypoxemia, hyaline membrane disease, patent ductus arteriosus are important risk factors related to neonatal pulmonary hemorrhage, and more attention and prevention should be paid to risk factors.