新生儿持续性肺动脉高压的危险因素分析  

Risk factors analysis of persistent pulmonary hypertension in neonates

作　　者：杨勇[1] 阮敏仪[1] 苏锦珍 谢伊玲[1] 李敏许[1] YANG Yong;Ruan Min-yi;SU Jin-zhen;XIE Yi-lin;LI Min-xu(Department of Neonatology,Dongguan Maternal and Child Health Hospital,Dongguan 523000,Guangdong,China)

机构地区：[1]东莞市妇幼保健院新生儿科,广东东莞523000

出　　处：《广东医学》2020年第4期344-348,共5页Guangdong Medical Journal

基　　金：东莞市社会科技发展(重点)项目(201750715007468)。

摘　　要：目的探讨新生儿持续性肺动脉高压的危险因素,为临床防治新生儿持续性肺动脉高压提供参考。方法回顾性收集2013年1月至2019年6月东莞市妇幼保健院诊断新生儿持续性肺动脉高压的新生儿117例作为肺动脉高压组(PPHN组),根据1∶1配对原则筛选同期住院期间胎龄无显著差异、无PPHN的117例患儿作为对照组,回顾性分析比较两组患儿相关临床表现,进而通过logistics回归分析新生儿PPHN的危险因素。结果两组基础情况包括胎龄、出生体重、性别差异均无统计学意义(P>0.05),两组分娩方式、阿氏评分(1 min、5 min、10 min)、宫内感染、羊水污染等差异均有统计学意义(P<0.05)。剖宫产(OR=3.087,95%CI:1.356~7.026,P=0.007)、胎粪吸入综合征(OR=46.436,95%CI:4.789~450.304,P=0.000)、新生儿呼吸性酸中毒(OR=8.126,95%CI:2.576~25.634,P=0.000)、新生儿呼吸窘迫综合征(OR=9.614,95%CI:4.104~22.519,P=0.000)、动脉导管未闭(OR=9.663,95%CI:3.980~23.461,P=0.000)为PPHN的危险因素。结论剖宫产、胎粪吸入综合征、新生儿呼吸性酸中毒、新生儿呼吸窘迫综合征、动脉导管未闭是新生儿持续性肺动脉高压的危险因素。Objective To investigate the risk factors of persistent pulmonary hypertension in neonates and provide guidance for the prevention and treatment of PPHN.Methods 117 neonates with persistent pulmonary hypertension were retrospectively collected as PPHN group from January in 2013 to June 2019 in Dongguan maternal and child health hospital.The control group was collected according to the 1∶1 matching principle during the same period of hospitalization.Risk factors of PPHN were analyzed by Logistics regression.Results Demographics,including gestational age,birth weight and gender between two groups were similar.There were statistically significant differences between the two groups in the delivery mode,the Apgar score(1 minute,5 minutes,10 minutes),amniotic fluid pollution,intrauterine growth restriction,neonatal asphyxia and other complications.According to the Logistics regression analysis,cesarean section(OR=3.087,95%CI:1.356-7.026,P=0.007<0.05),meconium aspiration syndrome(OR=46.436,95%CI:4.789-450.304,P=0.000<0.05),neonatal respiratory acidosis(OR=8.126,95%CI:2.576-25.634,P=0.000<0.05),respiratory distress syndrome(OR=9.614,95%CI:4.104-22.519,P=0.000<0.05)and patent ductus arteriosus(OR=9.663,95%CI:3.980-23.461,P=0.000<0.05)are the risk factors of PPHN.Conclusion Cesarean section,meconium aspiration syndrome,neonatal respiratory acidosis,respiratory distress syndrome and patent ductus arteriosus are the risk factors of PPHN.

关 键 词：新生儿持续性肺动脉高压 危险因素 新生儿 

分 类 号：R722[医药卫生—儿科] R725.6[医药卫生—临床医学]