新生儿无创呼吸支持治疗并发消化道出血的影响因素分析

Analysis of factors affecting complicated gastrointestinal bleeding after neonatal non-invasive respiratory support therapy

目的探讨新生儿无创呼吸支持治疗并发消化道出血的影响因素。方法选择2017年10月至2019年4月收治的使用无创呼吸支持治疗的128例新生儿作为研究对象。将治疗期间并发消化道出血的30例新生儿纳入出血组,未并发消化道出血的98例新生儿纳入未出血组。对两组新生儿的临床资料进行单因素和多因素分析,找出新生儿无创呼吸支持治疗并发消化道出血的影响因素。结果单因素结果表明:两组新生儿的胎龄、上机时间、出生体重、持续通气压力比较差异有统计学意义(P<0.05);多因素结果表明:胎龄<37周、上机时间≥4天、出生体重<1.5 kg、持续通气压力≥6 cmH2O是新生儿无创呼吸支持治疗并发消化道出血的危险因素(P<0.05)。结论胎龄、上机时间、出生体重、持续通气压力是新生儿无创呼吸支持治疗并发消化道出血的影响因素,无创呼吸支持治疗过程中需严格掌握好上机时间,并根据新生儿的具体临床体征给予合适的持续气道通气压力,以降低消化道出血的发生率。

Objective To investigate the influencing factors of complicated gastrointestinal bleeding after neonatal non-invasive respiratory support therapy.Methods A total of 128 newborns treated with noninvasive respiratory support therapy from October 2017 to April 2019 were selected as research subjects.30 newborns with gastrointestinal bleeding were included in the bleeding group,and 98 neonates without gastrointestinal bleeding during treatment were included in the non-bleeding group.Univariate and multivariate analysis were performed on the clinical data of the two groups of neonates to find out the influencing factors of gastrointestinal bleeding after noninvasive respiratory support treatment for neonatal bleeding.Results The single factor results indicated that there were statistically significant differences in gestational age,onset time,birth weight and continuous ventilation pressure between the two groups(P<0.05).Multi-factor results indicated that gestational age<37 weeks,operation time≥4 days,birth weight<1.5 kg,continuous ventilation pressure≥6 cmH 2O were risk factors for gastrointestinal bleeding during non-invasive respiratory support therapy(P<0.05).Conclusion Gestational age,operation time,birth weight and continuous ventilation pressure are the influencing factors of gastrointestinal bleeding during non-invasive respiratory support treatment.In the process of non-invasive respiratory support treatment,it is necessary to strictly control the time on the machine and give appropriate continuous airway ventilation pressure according to the specific clinical signs of the newborn,so as to reduce the incidence of gastrointestinal bleeding.