新生儿休克危险因素及病因分析

Risk factors and etiology of neonatal shock

目的探讨新生儿休克的病因及危险因素。方法将24h内发生休克的新生儿病例为休克组,将同期非休克病人作为对照组,比较两组一般情况、母亲因素、出生情况等因素差异,采用Logistic回归分析进行多因素分析,分析新生儿休克发生的病因。结果两组病人胎龄、出生体重、剖宫产、胎心异常、胎盘异常、PCT、CRP、APGAR评分及血气分析等参数的差异均有统计学意义(P<0.05),Logistic回归模型在调整了胎龄、剖宫产、胎心和胎盘等变量后出生第一分钟APGAR评分低于7分相对于正常APGAR评分的新生儿发生休克风险增加(OR=82.99,95%CI:20.21~340.86)。生后24h内发生新生儿休克病因主要是窒息。结论新生儿生后早期发生休克的原发病主要是新生儿窒息,发生新生儿休克的危险因素是早产、胎心异常、胎盘异常、1分钟APCAR评分低于7分。

Objective To investigate the etiology and risk factors of neonatal shock.Methods Infants born within 24h diagnosed as neonatal shock were enrolled into the shock group and non-shock patients were taken as the control group.General conditions,maternal factors,birth status and other factors in the two groups were compared.Logistic regression analysis was used for multivariate analysis.Results The gestational age,birth weight,cesarean section rate,abnormal fetal heart,abnormal placenta,PCT, CRP,APGAR score and blood gas were difference (P<0.05)between two groups.After adjusting gestational age,cesarean section rate,abnormal fetal heart,abnormal placenta the logistic regression model showed the first minute APGAR score below 7 points increase the risk of neonatal shock within 24h (OR = 82.99,95%CI:20.21 -340.86).The main cause of neonatal shock within 24 hours after birth was asphyxia.Conclusions The primary pathogenesis of early shock is neonatal asphyxia,and the risk factors of neonatal shock are premature birth,abnormal fetal heart,abnormal placenta,and the first minute APGAR score less than 7.