新生儿消化道出血相关危险因素分析  

Analysis of Risk Factors Related to Gastrointestinal Bleeding in Neonates

作　　者：杨雪 赵旭晶 杨小庆 YANG Xue;ZHAO Xujing;YANG Xiaoqing(Department of Neonatology,Yuncheng Central Hospital,Yuncheng 044000,China)

机构地区：[1]山西省运城市中心医院新生儿科,山西运城044000

出　　处：《医学综述》2022年第17期3494-3498,共5页Medical Recapitulate

基　　金：国家卫生健康委医药卫生科技发展研究中心课题(WA2020HK49)。

摘　　要：目的分析新生儿消化道出血的相关危险因素。方法收集2019年6月至2021年6月在山西医科大学附属运城医院出生的2996名新生儿的临床资料,根据是否发生消化道出血分为出血组和无出血组,对可能影响新生儿消化道出血的因素进行单因素和多因素Logistic回归分析。结果在2996名新生儿中,134例发生消化道出血,发生率为4.47%。两组性别以及新生儿高胆红素血症患儿占比比较差异无统计学意义(P>0.05),而出血组胎龄<37周、出生体重<2.5 kg、新生儿窒息、新生儿感染、新生儿缺血缺氧性脑病、新生儿颅内出血、新生儿肺炎、新生儿反流食性食管炎、新生儿顽固性呕吐患儿占比均明显高于无出血组[58.96%(79/134)比16.74%(479/2862)、55.22%(74/134)比9.33%(267/2862)、38.81%(52/134)比6.39%(183/2862)、38.06%(51/134)比6.67%(191/2862)、33.58%(45/134)比3.56%(102/2862)、14.93%(20/134)比7.62%(218/2862)、32.09%(43/134)比15.74%(422/2862)、6.72%(9/134)比0.98%(28/2862)、11.19%(15/134)比1.08%(31/2862)](均P<0.01)。多因素Logistic回归分析结果显示,胎龄<37周、出生体重<2.5 kg、新生儿窒息、新生儿感染、新生儿缺血缺氧性脑病、新生儿肺炎、新生儿顽固性呕吐是新生儿消化道出血的独立危险因素(OR=4.289,95%CI 1.292~14.232;OR=7.893,95%CI 1.477~42.174;OR=7.396,95%CI 1.861~29.395;OR=6.626,95%CI 1.313~33.447;OR=2.686,95%CI 1.234~5.848;OR=2.482,95%CI 1.188~5.186;OR=3.212,95%CI 1.178~8.763)(P<0.05或P<0.01)。结论胎龄<37周、出生体重<2.5 kg、新生儿窒息、新生儿感染、新生儿缺血缺氧性脑病、新生儿肺炎、新生儿顽固性呕吐是新生儿消化道出血的独立危险因素。Objective To analyze the risk factors of gastrointestinal bleeding in neonates.Methods The clinical data of 2996 neonates born in Yuncheng Hospital Affiliated to Shanxi Medical University from Jun.2019 to Jun.2021 were collected.According to the occurrence of gastrointestinal bleeding,they were divided into two groups:a bleeding group and a non-bleeding group.Univariate and multivariate Logistic regression analysis was conducted to analyze the possible influencing factors of neonatal gastrointestinal bleeding.Results Among the 2996 newborns,134 had gastrointestinal bleeding,with an incidence of 4.47%.There was no significant difference in gender or proportion of neonatal hyperbilirubinemia between the two groups(P>0.05).The incidences of gestational age<37 weeks,birth weight<2.5 kg,neonatal asphyxia,neonatal infection,neonatal hypoxic ischemic encephalopathy,neonatal intracranial hemorrhage,neonatal pneumonia,neonatal reflux esophagitis,and refractory vomiting in the bleeding group was significantly higher than those in the non-bleeding group[58.96%(79/134)vs 16.74%(479/2862),55.22%(74/134)vs 9.33%(267/2862),38.81%(52/134)vs 6.39%(183/2862),38.06%(51/134)vs 6.67%(191/2862),33.58%(45/134)vs 3.56%(102/2862),14.93%(20/134)vs 7.62%(218/2862),32.09%(43/134)vs 15.74%(422/2862),6.72%(9/134)vs 0.98%(28/2862),11.19%(15/134)vs 1.08%(31/2862)](all P<0.01).Multivariate Logistic regression analysis showed that gestational age<37 weeks,birth weight<2.5 kg,neonatal asphyxia,neonatal infection,neonatal hypoxic ischemic encephalopathy,neonatal pneumonia,and neonatal refractory vomiting were independent risk factors for neonatal gastrointestinal bleeding(OR=4.289,95%CI 1.292-14.232;OR=7.893,95%CI 1.477-42.174;OR=7.396,95%CI 1.861-29.395;OR=6.626,95%CI 1.313-33.447;OR=2.686,95%CI 1.234-5.848;OR=2.482,95%CI 1.188-5.186;OR=3.212,95%CI 1.178-8.763)(P<0.05 or P<0.01).Conclusion Gestational age<37 weeks,birth weight<2.5 kg,neonatal asphyxia,neonatal infection,neonatal hypoxic ischemic encephalopathy,neonatal pneumonia,neonatal refractor

关 键 词：消化道出血 新生儿 危险因素 

分 类 号：R722.152[医药卫生—儿科]