新生儿窒息复苏后发生持续性肺动脉高压的相关因素分析

Analysis of the related factors of the influence of persistent pulmonary hypertension after neonatal resuscitation

目的：探讨影响新生儿窒息复苏后发生持续性肺动脉高压的相关因素。方法回顾性分析商洛市妇幼保健院儿科2012年3月至2015年3月收治的256例窒息新生儿临床资料。其中窒息复苏后发生持续性肺动脉高压的新生儿136例，为观察组；复苏后未发生持续性肺动脉高压患儿120例，为对照组。通过回顾性分析两组患儿的病历情况，记录Apgar评分、窒息复苏前血压、血糖、体温及动脉血pH值。结果观察组患儿入院时收缩压、舒张压、体温、血糖、动脉血 pH 值分别为（49．27±8．08） mmHg、（22．25±5．17） mmHg、（34．40±0．41）℃、（2．78±0．65） mmol／L、7．11±0．79，均低于对照组（51．23±4．17） mmHg、（23．87±2．18） mmHg、（36．80±0．85）℃、（3．55±0．33） mmol／L、7．33±0．17，差异均有统计学意义（ t值分别为2．480、3．334、28．169、12．155、3．166，P均＜0．05）。低血糖、低体温、低收缩压、低舒张压是引起新生儿窒息复苏后发生持续肺动脉高压的影响因素（ OR值分别为3．660、1．930、8．903、4．543，95％CI值分别为1．061～12．631、1．399～2．661、1．166～67．962、1．636～12．613，P均＜0．05）。结论低血糖、低体温、低收缩压、低舒张压是引起新生儿窒息复苏后发生持续肺动脉高压的影响因素。

Objective To explore the related factors of the influence of persistent pulmonary hypertension（ PPH） after neonatal resuscitation. Methods Tow hundred and fifty-six cases asphyxia patients who were treated in the Maternal and Child Care Service Center of Shangluo from March 2012 to March 2015 were retrospectively analyzed. One hundred and thirty-six newborns asphyxia of persistent pulmonary hypertension were selected as the observation group. One hundred and twenty newborns asphyxia without persistent pulmonary hypertension were selected as the control group. Medical records of children of two groups were retrospectively analyzed. Apgar scores of all observed objects. Before resuscitation blood pressure, blood glucose, body temperature,blood pH value of children in the two groups were recorded. Results In admission, the systolic blood pressure,diastolic blood pressure,body temperature,blood sugar,blood pH value in the observation group （（49. 27±8. 08） mmHg,（22. 25±5. 17） mmHg,（34. 40±0. 41）℃,（2. 78±0. 65） mmol/L,（7. 11±0. 79）） were lower than that in the control group（（51. 23±4. 17） mmHg,（23. 87±2. 18） mmHg,（36. 80±0. 85）℃, （3. 55±0. 33） mmol/L,（7. 33±0. 17））,the differences were statistically significant（t=2. 480,3. 334,28. 169, 12. 155,3. 166;P〈0. 05） . Hypoglycemia,hypothermia,low systolic blood pressure,low diastolic blood pressure were identified as the impact factors that can cause neonatal resuscitation after persistent pulmonary hypertension （ OR=3. 660,1. 930,8. 903,4. 543;95%CI=1. 061-12. 631,1. 399-2. 661,1. 166-67. 962,1. 636-12. 613;P〈0. 05）. Conclusion Hypoglycemia,hypothermia,low systolic blood pressure and low diastolic blood pressure are impact factors can cause neonatal resuscitation after persistent pulmonary hypertension.