摘要
目的探讨极低/超低出生体重儿动脉导管未闭(patent ductus arteriosus,PDA)结扎术后发生低血压的危险因素。方法回顾性选择2016年3月至2021年1月在南方医科大学附属深圳妇幼保健院新生儿重症监护病房进行床旁PDA结扎术、出生体重<1500 g的早产儿为研究对象,根据术后72 h内是否发生低血压分为低血压组和非低血压组,比较两组一般情况、围手术期情况,采用多因素Logistic回归分析PDA结扎术后发生低血压的危险因素。结果共纳入44例,低血压组11例,非低血压组33例。单因素分析结果显示,低血压组手术时体重<1100 g、术前需高频振荡通气(high frequency oscillatory ventilation,HFOV)比例高于非低血压组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,手术时体重<1100 g(OR=12.045,95%CI 1.351~107.394,P=0.026)、术前需HFOV(OR=27.832,95%CI 1.363~568.292,P=0.031)是极低/超低出生体重儿PDA结扎术后发生低血压的独立危险因素。结论低血压是极低/超低出生体重儿PDA结扎术常见并发症之一,手术时体重<1100 g、术前需HFOV是术后发生低血压的危险因素。
Objective To study the risk factors of hypotension after ligation of patent ductus arteriosus(PDA)in very/extremely low birth weight infants(VLBWI/ELBWI).Method From March 2016 to January 2021,preterm infants with birth weight<1500 g receiving bedside PDA ligation in the neonatal intensive care unit(NICU)of our hospital were enrolled in the study.According to the occurrence of hypotension within 72 hours after ligation,the infants were assigned into non-hypotension group and hypotension group.The general status and perioperative conditions of the two groups were analyzed.Multivariate Logistic regression was used to analyze the risk factors of hypotension.Result A total of 44 cases were enrolled,including 33 in non-hypotension group and 11 in hypotension group.Univariate analysis showed that hypotension group had significantly more cases with body weight<1100 g during surgery and receiving preoperative high frequency oscillatory ventilation(HFOV)than non-hypotension group(P<0.05).Multivariate Logistic regression analysis showed that weight<1100 g during surgery(OR=12.045,95%CI 1.351~107.394,P=0.026)and receiving preoperative HFOV(OR=27.832,95%CI 1.363~568.292,P=0.031)were independent risk factors of hypotension.Conclusion Hypotension is one of the common complications of PDA ligation in VLBWI/ELBWI.The infant's body weight during ligation and receiving preoperative HFOV are independent risk factors of hypotension.
作者
郑学辉
姚芳
陈春
余彦亮
林冰纯
赵捷
黄智峰
杨传忠
Zheng Xuehui;Yao Fang;Chen Chun;Yu Yanliang;Lin Bingchun;Zhao Jie;Huang Zhifeng;Yang Chuanzhong(Department of Neonatology,Shenzhen Maternity&Child Healthcare Hospital Affiliated to Southern Medical University,Shenzhen 518028,China)
基金
广东省高水平临床重点专科(SZGSP009)
深圳市“医疗卫生三名工程”资助项目(SZSM201612045)。
关键词
婴儿
极低出生体重
婴儿
超低出生体重
动脉导管未闭
低血压
危险因素
Infant,very low birth weight
Infant,extremely low birth weight
Patent ductus arteriosus
Hypotension
Risk factors