新生儿窒息复苏后发生持续肺动脉高压的危险因素探讨

Risk factors of persistent pulmonary hypertension after neonatal asphyxia and resuscitation

目的探究新生儿窒息复苏后发生持续肺动脉高压的危险因素。方法选取2019年11月至2020年11月本院收治的66例持续肺动脉高压患儿作为研究组,另选取同期于本院出生的66名健康新生儿作为参照组。比较两组体温、血压及血糖、血乳酸、血气指标水平,比较不同窒息程度患儿体温、血压、血糖及血乳酸水平,比较不同窒息程度患儿轻度、中度及重度肺动脉高压占比情况。结果研究组体温、血压及血糖水平均低于参照组,血乳酸水平高于参照组,差异有统计学意义(P<0.05)。研究组动脉血pH值低于参照组,差异有统计学意义(P<0.05);两组动脉血二氧化碳分压、动脉血氧分压及二氧化硫水平比较差异无统计学意义。轻度窒息患儿体温、血压、血糖及血乳酸水平与重度窒息患儿比较差异无统计学意义。轻度窒息患儿轻度肺动脉高压、中度肺动脉高压及重度肺动脉高压占比与重度窒息患儿比较差异无统计学意义。结论低血糖、低体温、低血压及酸中毒是新生儿窒息复苏后发生持续肺动脉高压的危险因素,窒息严重程度不会对持续肺动脉高压的病情严重程度产生影响。

Objective To explore the risk factors of persistent pulmonary hypertension after neonatal asphyxia and resuscitation.Methods 66 children with persistent pulmonary hypertension admitted to our hospital from November 2019 to November 2020 were selected as the study group,and 66 healthy newborns born in our hospital during the same period were selected as the reference group.The body temperature,blood pressure,blood glucose level,blood lactic acid level and blood gas index level of the two groups were compared,the body temperature,blood pressure,blood glucose and blood lactic acid levels of children with different degrees of asphyxia were compared,the proportion of children with mild,moderate and severe pulmonary hypertension with different degrees of asphyxia was compared.Results The body temperature,blood pressure and blood glucose levels in the study group were lower than those in the reference group,and the blood lactic acid level was higher than that in the reference group,the differences were statistically significant(P<0.05).The arterial blood pH value in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05);there was no significant difference in arterial partial pressure of carbon dioxide,arterial partial pressure of oxygen and sulfur dioxide levels between the two groups.There was no significant difference in body temperature,blood pressure,blood glucose and blood lactate levels between children with mild asphyxia and children with severe asphyxia.There was no significant difference in the proportion of mild pulmonary hypertension,moderate pulmonary hypertension and severe pulmonary hypertension between children with mild asphyxia and severe asphyxia.Conclusion Low blood glucose level,low body temperature,low blood pressure and acidosis are risk factors for persistent pulmonary hypertension after neonatal asphyxia and resuscitation,the severity of asphyxia will not affect the severity of persistent pulmonary hypertension.