超早产儿出生早期循环相关并发症的危险因素分析

Risk factors of circulation-related complications in early period of extremely preterm infants′life

目的探讨超早产儿出生早期循环相关并发症的危险因素。方法回顾性收集2015年1月至2019年12月于本院出生并转入新生儿重症监护病房进行治疗的超早产儿的病例相关信息,按照纳入及排除标准,共107例超早产儿纳入本研究。按照生后7 d内是否有与循环相关的并发症(包括肺出血、重度脑室内出血、心力衰竭、肾功能衰竭、新生儿坏死性小肠结肠炎、休克),分为观察组(53例)和对照组(54例),采用独立样本t检验、秩和检验、χ^(2)检验及多因素二元Logistic回归分析超早产儿生后早期循环相关并发症的危险因素。结果多因素Logistic回归分析显示,双胎(OR=4.30,95%CI=1.16~15.98,P=0.029)、新生儿窒息(OR=4.63,95%CI=1.28~16.74,P=0.020)、新生儿生后第1天入量>85.0 mL/kg(OR=4.20,95%CI=1.05~16.79,P=0.049)、动脉导管未闭(PDA)≥3.0 mm(OR=3.92,95%CI=1.12~13.76,P=0.033)是超早产儿生后早期循环相关并发症的危险因素。结论双胎、新生儿窒息、新生儿生后第1天入量>85.0 mL/kg、PDA≥3.0 mm是超早产儿生后早期循环相关并发症的独立危险因素,出生早期需严密监测和及时处理。

Objective To investigate the risk factors of circulation-related complications in early period of extremely preterm infants′life.MethodsInformation related to extremely premature infants born in our hospital from January 2015 to December 2019 and transferred to neonatal intensive care unit for treatment was retrospectively collected.According to inclusion and exclusion criteria,a total of 107 extremely premature infants were included in this study.The infants were divided into observation group(n=53)and control group(n=54),according to the presence of circulation-related complications(including pulmonary hemorrhage,severe intraventricular hemorrhage,heart failure,renal failure,neonatal necrotizing enterocolitis,and shock)within 7 days after birth.Independent sample T test,rank-sum test,chi-square test and multivariate logistic regression were used to analyze the risk factors of circulation-related complications in early period of these extremely preterm infants′life.ResultsMultivariate logistic regression analysis showed that twins(OR=4.30,95%CI=1.16-15.98,P=0.029),neonatal asphyxia(OR=4.63,95%CI=1.28-16.74,P=0.020),liquid intake>85.0 mL/kg in the first day after birth(OR=4.20,95%CI=1.05-16.79,P=0.049),patent ductus arteriosus(PDA)≥3.0mm(OR=3.92,95%CI=1.12-13.76,P=0.033)were risk factors for circulation-related complications in extremely preterm infants.ConclusionTwins,neonatal asphyxia,liquid intake>85.0 mL/kg in the first day after birth,PDA≥3.0 mm were independent risk factors for circulation-related complications in early period of extremely preterm infants′life,close monitoring and timely treatment are required after birth.