2020年厦门市新生儿呼吸道疾病筛查及随访结果分析

Analysis of Screening and Follow-up Results of Neonatal Respiratory Diseases in Xiamen in 2020

目的:调查某地区新生儿呼吸道疾病筛查及随访情况。方法:选取2020年1月1日~2020年12月31日厦门市医疗机构出生的新生儿115424例,筛查新生儿呼吸衰竭发生、治疗及随访预后情况,调查分析新生儿死亡的危险因素。结果:诊断为呼吸衰竭352例(0.30%);其原发病为新生儿呼吸窘迫综合征和(或)严重湿肺138例(39.20%),新生儿肺炎98例(27.84%),新生儿窒息68例(19.32%);随访发现,死亡67例,死亡率为19.03%,最终治愈出院的患儿285例,存活率为80.97%。多元Logistic回归进行逐步回归分析,SNAPPE-Ⅱ评分、肺表面活性物质使用、吸入一氧化氮、机械通气均是导致死亡的危险因素(P<0.05)。结论:新生儿中呼吸衰竭的筛查率比较高,患儿常并发肾衰竭,随访发现患儿有较高的死亡率,SNAPPE-Ⅱ评分、肺表面活性物质使用、吸入一氧化氮、机械通气为重要因素。

Objective:To investigate the screening and follow-up of neonatal respiratory diseases in a certain area.Methods:115,424 newborns born in Xiamen medical institutions from January 1,2020 to December 31,2020 were screened for the occurrence,treatment,and follow-up prognosis of neonatal respiratory failure and the the risk factors for neonatal death were investigated and analyzed.Results:352 cases(0.30%)were diagnosed with respiratory failure,including 138 cases(39.20%)with protopathy of neonatal respiratory distress syndrome and/or severe wet lung,98 cases(27.84%)with neonatal pneumonia,and 68 cases with neonatal asphyxia(19.32%);The follow-up found that 67 cases died,the mortality rate was 19.03%,285 cases were cured and discharged,and the survival rate was 80.97%.Multivariate Logistic regression for stepwise regression analysis showed that SNAPE-Ⅱscore,pulmonary surfactant use,inhalation of nitric oxide,and mechanical ventilation were all risk factors for death(P<0.05).Conclusion:The screening rate of respiratory failure among newborns is relatively high,and the children are often complicated with renal failure.The follow-up shows that the children patients have higher mortality rate,and SNAPE-Ⅱscore,pulmonary surfactant use,inhaled nitric oxide,and mechanical ventilation are important factor.