新生儿双侧气胸高危因素分析  

Clinical risk factors of bilateral pneumothorax in neonates

作　　者：许邦礼 刘大鹏 金娟 李朝晖 周炎娟 李蕊 王颖源 王彩君 康文清 XU Bangli;LIU Dapeng;JIN Juan;LI Zhaohui;ZHOU Yanjuan;LI Rui;WANG Yingyuan;WANG Caijun;KANG Wenqing(Neonatal Center,Henan Children's Hospital,Henan Zhengzhou 450000,China)

机构地区：[1]河南省儿童医院/郑州儿童医院新生儿疾病诊治中心,河南郑州450000

出　　处：《中国妇幼健康研究》2020年第11期1503-1506,共4页Chinese Journal of Woman and Child Health Research

基　　金：河南省医学科技攻关计划省部共建项目(2018010041)。

摘　　要：目的探讨新生儿双侧气胸的高危因素,为临床诊治提供帮助。方法选择2014年10月至2017年12月于郑州儿童医院新生儿诊治中心诊断的87例气胸患儿为研究对象,其中23例双侧气胸患儿为观察组,64例单侧气胸为对照组,回顾性分析其临床资料,统计分析双侧气胸的高危因素及特征。结果本研究观察组死亡10例(43.48%),对照组死亡5例(7.81%),观察组机械通气时间、住院时间均显著长于对照组,胸腔闭式引流率、死亡率均显著高于对照组(t/χ^2值分别为5.308、4.147、9.824、15.084,均P<0.05)。单因素分析显示两组在性别、出生体质量、胎龄方面均无统计学差异,而胎膜早破、剖宫产、产妇腰椎麻醉时差异有统计学意义,观察组发病率高(χ^2值分别为4.107、4.446、5.554,均P<0.05),且两组患儿5分钟Apgar评分≤7、面罩球囊正压通气、胎粪吸入综合征(MAS)均存在显著性差异(χ^2值分别为11.190、9.203、4.896,均P<0.05);多因素非条件Logistic回归分析结果显示5分钟Apgar评分≤7、接受面罩球囊正压通气为其独立高危因素,其OR值及95%CI分别为2.343(1.443~3.857)、1.623(1.182~2.798),均P<0.05。结论5分钟Apgar评分≤7、接受面罩球囊正压通气与新生儿双侧气胸发病相关,若临床规避高危因素,并熟练面罩球囊正压通气等,可减少新生儿双侧气胸的发病率及病死率。Objective To explore risk factors of bilateral pneumothorax in newborns and provide strategies for clinical diagnosis and treatment.Methods A total of 87 children with pneumothorax and diagnosed at the Neonatal Center of Henan Children’s Hospital from October 2014 to December 2017 were selected as the research objects.The neonates with bilateral pneumothorax were divided into study group,while 64 children with unilateral pneumothorax were selected as the control group.The data were retrospectively collected and the high-risk factors and characteristics of bilateral pneumothorax were statistically analyzed.Results 10 cases(43.48%)were clinically dead in study group,while 5 cases(7.81%)were dead in control group.Mechanical ventilation time,rate of closed thoracic drainage,hospitalization time and mortality in study group were all significantly higher than those in control group(t/χ^2 values were 5.308,4.147,9.824 and 15.084,respectively,all P<0.05).There was no significant difference in gender,birth weight and gestational week between the two groups.But the incidence of premature rupture of membrane,caesarean delivery and lumbar anesthesia for pregnant women in study group were all higher that those in control group(χ^2 values were 4.107,4.446 and 5.554,respectively,all P<0.05).And significant differences were also found in 5 minute Apgar score≤7 min,positive pressure ventilation by mask balloon,and meconium aspiration syndrome(MAS)between the two groups(χ^2 values were 11.190,9.203 and 4.896,respectively,all P<0.05).Non-conditional logistics regression analysis showed that the independent risk factors of bilateral pneumothorax were 5 minute Apgar score≤7 and bag mask positive pressure ventilation(OR values and 95%CI were 2.343(1.443-3.857)and 1.623(1.182-2.798),respectively,both P<0.05).Conclusion Five minutes Apgar score≤7 and bag mask positive pressure ventilation are associated with the incidence of bilateral pneumothorax of newborns.In order to reduce the incidence and mortality of newborns with bil

关 键 词：气胸 高危因素 特征 新生儿 

分 类 号：R722.1[医药卫生—儿科]