新生儿窒息复苏后持续肺动脉高压的影响因素  

Influencing Factors of Persistent Pulmonary Hypertension after Neonatal Asphyxia Resuscitation

作　　者：曹娜 CAO Na(Department of Neonatology,Yongzhou Central Hospital,Yongzhou 425000,China)

机构地区：[1]湖南省永州市中心医院新生儿科,湖南永州425000

出　　处：《中国医药指南》2023年第22期110-112,共3页Guide of China Medicine

摘　　要：目的对新生儿窒息复苏后发生持续肺动脉高压(PPHN)的影响因素进行分析,为其预防提供依据。方法收集2020年4月至2021年12月我院收治的103例新生儿窒息患儿回顾分析其临床资料,患儿均接受复苏治疗,根据有无发生复苏后PPHN分为PPHN组14例和无PPHN组89例,比较两组患儿的一般资料,复苏后监测指标,采用Logistic回归性分析讨论新生儿窒息复苏后发生PPHN的影响因素。结果PPHN组收缩压、舒张压、血糖、体温、动脉血pH值、PaO_(2)/FiO_(2)均显著低于无PPHN组,P<0.05;而PPHN组血乳酸水平则显著高于无PPHN组,P<0.05。Apgar评分≤3分重度窒息(OR=3.595,95%CI:0.746~4.029)、低体温(OR=4.261,95%CI:2.008~8.653)、低血糖(OR=5.028,95%CI:1.857~7.362)、低血压(OR=5.737,95%CI:2.225~6.374)、酸中毒(OR=3.089,95%CI:1.829~4.951)、高乳酸血症(OR=6.057,95%CI:2.679~8.145)、低PaO_(2)/FiO_(2)(OR=7.019,95%CI:4.398~23.559)为新生儿窒息复苏后发生PPHN的独立危险因素。结论新生儿窒息复苏临床救治中必须对新生儿窒息复苏后的Apgar评分、体温、血压、血糖、动脉血pH值、血乳酸水平、PaO_(2)/FiO_(2)进行严密监测,通过积极采取有效措施维持其稳定水平,从而预防PPHN的发生,改善预后。Objective To analyze the influencing factors of persistent pulmonary hypertension(PPHN)after neonatal asphyxia resuscitation and provide a basis for its prevention.Methods A retrospective analysis of clinical data was conducted on 103 newborns with asphyxia admitted to our hospital from April 2020 to December 2021.All patients received resuscitation treatment and were divided into a PPHN group of 14 cases and a non PPHN group of 89 cases based on the presence or absence of persistent pulmonary hypertension after resuscitation.The general data and monitoring indicators after resuscitation were compared between the two groups.Logistic regression analysis was used to discuss the influencing factors of persistent pulmonary hypertension after neonatal asphyxia resuscitation.Results The systolic blood pressure,diastolic blood pressure,blood sugar,body temperature,arterial blood pH,PaO_(2)/FiO_(2) in PPHN group were significantly lower than those in PPHN group(P<0.05).The blood lactate level in the PPHN group was significantly higher than that in the non PPHN group,P<0.05.Apgar score≤3 points:severe asphyxia(OR=3.595,95%CI:0.746-4.029),hypothermia(OR=4.261,95%CI:2.008-8.653),hypoglycemia(OR=5.028,95%CI:1.857-7.362),hypotension(OR=5.737,95%CI:2.225-6.374),acidosis(OR=3.089,95%CI:1.829-4.951),hyperlactatemia(OR=6.057,95%CI:2.679-8.145),and low PaO_(2)/FiO_(2)(OR=7.019,95%CI:4.398-23.559)are independent risk factors for PPHN after neonatal asphyxia resuscitation.Conclusion The Apgar score,body temperature,blood pressure,blood sugar,arterial blood pH,blood lactate level,PaO_(2)/FiO_(2) must be closely monitored after neonatal asphyxia resuscitation in clinical treatment,and effective measures should be taken to maintain its stable level,so as to prevent the occurrence of persistent pulmonary hypertension and improve the prognosis.

关 键 词：新生儿窒息 复苏 持续肺动脉高压 危险因素 

分 类 号：R722.12[医药卫生—儿科]