高危新生儿期危险因素及与出生胎龄的相关性研究

Risk factors of high-risk infants in neonatal period and their correlation with the gestational age

目的通过分析高危新生儿期危险因素的发生率及与出生胎龄的相关性,探讨其可能的发病机制。方法 2012年6月至2013年6月大连市儿童医院收治住院的高危新生儿1 800例,随机抽取1 000例高危儿中发生在新生儿期的高危儿780例。采用《IMOCH婴幼儿高危因素评分表》结合新生儿住院期间病历记录,对高危儿的危险因素进行收集。结果高危儿在新生儿期的发生率为78%,其中危险因素百分率从高到低(>10%)的依次排序为:新生儿期患感染性疾病:如肺炎等(51.28%)、胎龄<37周(47.56%)、新生儿病理性黄疸(22.69%)、新生儿期出现呼吸障碍青紫现象(22.43%)、新生儿期出现易激惹尖叫现象(18.08%)、听力筛查异常(14.62%)、新生儿缺血缺氧性脑病(12.05%),并以单种因素(33.29%)和两种因素合并(32.53%)为主,且新生儿缺血缺氧性脑病、新生儿惊厥和新生儿期出现易激惹尖叫现象与高危儿出生胎龄正相关(P<0.05),新生儿出现呼吸障碍青紫现象与高危儿出生胎龄负相关(P<0.05)。结论高危儿在新生儿期的危险因素是多种的,各因素间相互作用相互影响,并且部分因素与出生胎龄也密切相关。

Objective To explore the possible mechanism of the risk factors of high risk infants in the neonatal period by analyzing the incidence of risk factors and correlation between risk factors and gestational age in neonatal period of high-risk infants.Methods A total of 1 800high-risk neonates were admitted to Dalian Children＇s Hospital for treatment form June 2012 to June 2013.Totally 1 000 neonates were randomly chosen,among whom 780 were during the neonatal period.IMOCH High-risk Scoring for Infants was used and combined with the case record during hospital stay,the risk factors were collected.Results The incidence of high-risk infants in the neonatal period was 78%.The percentage of risk factors from high to low（over 10%）was neonatal infectious disease（Pneumonia,etc.51.28%）,less than 37 weeks of gestation（47.56%）,neonatal pathological jaundice（22.69%）,respiratory cyanosis in the neonatal period（22.43%）,excited scream in the neonatal period（18.08%）,abnormal hearing screening（14.62%）,and hypoxic-ischemic encephalopathy（12.05%）.Single factor（33.29%）and combination of two factors（32.53%）were most common.Hypoxic-ischemic encephalopathy,convulsions and excited scream in the neonatal period had positive correlation with the gestational age of high-risk infants（P〈0.05）.Respiratory cyanosis in the neonatal period had negative correlation with the gestational age of high-risk infants（P〈0.05）.Conclusion The risk factors of high-risk infants in the neonatal period are various,and they interact with each other;some of these factors were also closely related to the gestational age.