新生儿胎粪吸入综合征预后关联因素分析及预测意义

Analysis of the related factors of the prognosis outcomes of neonatal meconium aspiration syndrome and the predictive significance of the factors for the neonatal prognosis

目的:探究新生儿胎粪吸入综合征(MAS)预后结局的关联因素及预测意义。方法:回顾性分析2016年5月-2022年5月本院收治的MAS新生儿108例临床资料,根据治疗结果分为成功组与失败组并比较两组一般资料,多因素logistic回归法分析新生儿MAS预后结局的关联因素,受试者工作特征(ROC)曲线分析关联因素对新生儿MAS预后结局的预测价值。结果:108例MAS新生儿中,有21例院内死亡或放弃治疗(失败组),不良预后19.4%;成功组87例。多因素分析显示,窒息史(OR=1.370)、羊水污染程度高(OR=1.563)均是影响新生儿MAS预后结局的独立危险因素,补充益生菌(OR=0.700)、高动脉血氧分压(PaO_(2))/吸入氧浓度(FiO_(2))(OR=0.770)是新生儿MAS预后结局的保护因素(均P<0.05),PaO_(2)/FiO_(2)预测新生儿MAS预后的曲线下面积为0.970,价值较高。结论:窒息史、羊水污染程度、补充益生菌、PaO_(2)/FiO_(2)均与是新生儿MAS预后结局影响因素,PaO_(2)/FiO_(2)有一定预测价值,早期识别危险因素并制定干预措施对改善患儿预后有益。

Objective:To explore the related factors of the prognosis outcomes of neonatal meconium aspiration syndrome(MAS),and to study the predictive significance of the factors for MAS.Methods:The clinical data of 108 neonates with MAS admitted to the hospital from May 2016 to May 2022 were analyzed retrospectively.According to the treatment results,these neonates were divided into group A(neonates with successful treatment)and group B(neonates with failure treatment).The general data of the neonates were compared between the two groups.Multivariate logistic regression analysis was used to analyze the related factors of the prognosis outcomes of the neonates with MAS.The predictive value of the related factors of the neonates with MAS for their prognosis outcomes was analyzed by receiver operating characteristic(ROC)curve.Results:Among 108 neonates with MAS,21 neonates who had died in hospital or had given up treatment were in group A,and with the proportion of the poor prognosis of 19.4%.There were 87 neonates in group B.Multivariate analysis showed that the history of asphyxia(OR=1.370),the high degree of amniotic fluid pollution(OR=1.563)of the neonates with MAS were the independent risk factors affecting their prognosis.The supplementation of probiotics(OR=0.700)and the value of arterial partial pressure of oxygen(PaO_(2))/fraction of inspired oxygen(FiO_(2))(OR=0.770)of the neonates with MAS were the protective factors of their prognosis(all P<0.05).The value of the area under the curve of PaO_(2)/FiO_(2) of the neonates with MAS for predicting their prognosis was 0.970,and which was higher.Conclusion:The history of asphyxia,the degree of amniotic fluid pollution,the supplementation of probiotics and the PaO_(2)/FiO_(2) value of the neonates with MAS were the factors affecting their prognosis.The value of PaO_(2)/FiO_(2) of the neonates has certain value for predicting their prognosis.Early identification of these risk factors and the intervention measures conducted can improve the prognosis of the neonates.