新生儿重症监护室内呼吸衰竭的高危因素分析  

Analysis of high risk factors for respiratory failure in neonatal intensive care unit

作　　者：顾洁 袁娇 徐会莹 GU Jie;YUAN Jiao;XU Huiying(Maternal and Child Health Hospital of Yinchuan,Yinchuan 750001,China)

机构地区：[1]宁夏银川市妇幼保健院,宁夏银川750001

出　　处：《宁夏医学杂志》2022年第12期1071-1074,共4页Ningxia Medical Journal

基　　金：宁夏回族自治区科技支撑计划项目(2012ZYS217);宁夏自然科学基金资助项目(2021AAC03522)。

摘　　要：目的 分析新生儿重症监护室内呼吸衰竭的高危因素。方法 收集新生儿重症监护室内诊断新生儿呼吸衰竭(NRF)201例(研究组)和同期住院未诊断NRF201例(对照组)患儿的临床资料,分析2组间的一般资料、原发疾病构成,并使用二元logistic回归分析NRF的相关危险因素。结果 胎龄、出生体重、居住农村、妊娠期并发症、宫内窘迫、多胎妊娠及1、5 min Apgar评分在2组中差异有统计学意义(P<0.05)。导致NRF的原发疾病前三位分别为感染性肺炎(41.67%)、新生儿呼吸窘迫综合征(25.37%)及新生儿窒息(13.43%),由新生儿窒息、新生儿呼吸窘迫综合征疾病导致的NRF发病率高于未发生呼吸衰竭者(P<0.05)。对早产、居住城市、多胎妊娠、宫内窘迫、妊娠并发症、新生儿呼吸窘迫综合征6个因素差异有统计学意义的因素进行二元logistic回归分析,早产是NRF的危险因素(P<0.05),居住城市是NRF的保护因素(P<0.05)。在研究组25例放弃治疗的NRF患儿中,12例出院后死亡(其中83.3%为早产儿)。对照组9例放弃治疗的NRF患儿,其中1例因败血症放弃治疗而出院后死亡,研究组的放弃治疗后院外病死率明显高于对照组。结论 新生儿重症监护室内NRF的发病率与多种因素有关,其中早产及窒息是导致呼吸衰竭的重要原因,注意加强孕产保健工作和及时有效的院内转运,减少早产及窒息的发生率,对降低新生儿呼吸衰竭的发病率至关重要。Objective To analyze the risk factors of respiratory failure in neonatal intensive care unit(NICU).Methods The clinical data of 201 patients diagnosed with neonatal respiratory failure(NRF) and the patients without NRF diagnosis in the neonatal intensive care unit were collected. The general data, the composition of primary disease between the two groups were analyzed, and the associated risk factors for NRF were analyzed by binary logistic regression.Results There were significant differences in gestational age, birth weight, rural area, complications during pregnancy, intrauterine distress, multiple pregnancy and Apgar scores at 1 and 5 minutes between the two groups(P<0.05). The top three primary diseases causing NRF were infectious pneumonia(41.67%),neonatal respiratory distress syndrome(25.37%) and neonatal asphyxia(13.43%),respectively. The incidence of NRF caused by neonatal asphyxia and neonatal respiratory distress syndrome was significantly higher than that in the group without respiratory failure(P<0.05). The binary logistic regression analysis was performed on 6 factors with significant differences, including preterm birth, urban, multiple pregnancy, intrauterine distress, pregnancy complications, and neonatal respiratory distress syndrome. The preterm birth was the risk factor for NRF(P<0.05),and city was the protective factor of NRF(P<0.05). Among 25 NRF patients who abandoned treatment, 12 died after discharge(83.3% of them were preterm infants). Among 9 NRF patients who gave up treatment in the control group, 1 died after giving up treatment due to sepsis. The out-of-hospital mortality rate in the NRF group was significantly higher than that in the group without respiratory failure.Conclusion The incidence of NRF in the neonatal intensive care unit is related to many factors, among which preterm birth is an important cause of respiratory failure. It is very important to strengthen the maternal health care in this region and to reduce the incidence of preterm birth, which helps to reduce the incide

关 键 词：新生儿重症监护室 呼吸衰竭 高危因素 

分 类 号：R285[医药卫生—中药学]