新生儿肺出血的相关危险因素分析及防控策略

Analysis of risk factors related to neonatal pulmonary hemorrhage and its prevention and control strategies

目的对新生儿肺出血(NPH)患儿相关危险因素进行分析,并探讨预防控制策略,为降低其发生率、改善患儿结局提供依据。方法采用回顾性研究方法,选择本院2014年1月至2019年6月的49例NPH患儿作为研究组,并选取同时期的100例新生儿作为对照组。观察孕产妇、孕产期胎儿情况及新生儿等相关影响因素。结果研究组产妇妊娠期高血压(18.37%)、剖宫产(63.27%)、胎盘早剥(16.33%)、胎膜早破(38.77%)、宫内窘迫(28.57%)、羊水污染(18.37%)、胎粪吸入(16.33%)、早产儿(38.37%)、低体质量儿(40.82%)、感染性肺炎(20.41%)、弥漫性血管内凝血(18.37%)、新生儿窒息(36.73%)、呼吸窘迫综合征(32.65%)发生率均高于对照组的2.00%、36.00%、0.00%、1.00%、1.00%、1.00%、0.00%、1.00%、1.00%、0.00%、0.00%、2.00%、0.00%,差异具有统计学意义(P<0.05)。研究组胎龄、新生儿体质量、5 min Apgar评分结果分别为(38.40±4.86)周、(2784.63±154.92)g、(7.25±1.36)分,均低于对照组(41.86±3.27)周、(3162.95±172.65)g、(9.71±1.29)分,差异具有统计学意义(P<0.05)。结论NPH发生原因较多,多种因素并存,胎龄、新生儿体质量、妊娠期高血压、胎盘早剥、胎膜早破、剖宫产、宫内窘迫、羊水污染、胎粪吸入、感染性肺炎、弥漫性血管内凝血、新生儿窒息、呼吸窘迫综合征等是NPH发生的主要危险因素,临床应加强孕产妇保健,采取有效治疗等措施降低其发生率,改善患儿预后。

Objective To analyze the risk factors related to neonatal pulmonary hemorrhage(NPH),and explore its prevention and control strategies,to provide the basis for reducing the incidence and improving the outcome of children.Methods By retrospective study,49 NPH children in our hospital from January in 2014 to June in 2019 were selected as the study group,and 100 newborns during the same period were selected as the control group.The maternal,fetal and neonatal conditions and other related factors were observed.Results The incidence of hypertension(18.37%),cesarean section(63.27%),placental abruption(16.33%),premature rupture of membranes(38.77%),intrauterine distress(28.57%),amniotic fluid contamination(18.37%),meconium inhalation(16.33%),preterm infants(38.37%),low body mass(40.82%),infectious pneumonia(20.41%),diffuse intravascular coagulation(18.37%),neonatal asphyxia(36.73%),respiratory distress syndrome(32.65%)in the study group were higher than those in the control group 2.00%,36.00%,0.00%,1.00%,1.00%,1.00%,0.00%,1.00%,1.00%,0.00%,0.00%,2.00%,0.00%,the differences were statistically significant(P<0.05).The gestational age,neonatal body weight,and 5 min Apgar scores in the study group were(38.40±4.86)weeks,(2784.63±154.92)g and(7.25±1.36)points,which were lower than(41.86±3.27)weeks,(3162.95±172.65)g,(9.71±1.29)points in the control group,the differences were statistically significant(P<0.05).Conclusion There are many causes for NPH,and many factors coexist.Fetal age,neonatal weight,pregnancy hypertension,placental abruption,premature rupture of membranes,cesarean section,intrauterine distress,amniotic fluid pollution,meconium inhalation,infective pneumonia,diffuse intravascular coagulation,neonatal asphyxia,respiratory distress syndrome are the main risk factors for NPH.Clinically,maternal health care should be strengthened and adopted.Effective treatment and other measures can reduce the incidence and improve the prognosis of children.