临床儿科杂志 ›› 2015, Vol. 33 ›› Issue (7): 627-.doi: 10.3969 j.issn.1000-3606.2015.07.007

• 综合报道 • 上一篇    下一篇

34 周及以上胎龄新生儿呼吸衰竭预后分析

朱天闻,张永红,陈妍,钱继红   

  1. 上海交通大学医学院附属新华医院新生儿科( 上海 200092)
  • 收稿日期:2015-07-15 出版日期:2015-07-15 发布日期:2015-07-15
  • 通讯作者: 钱继红 E-mail:qianjh668@126.com

Analysis of the factors influencing prognosis of respiratory failure in neonates with gestational age of 34 weeks or more 

ZHU Tianwen, ZHANG Yonghong, CHEN Yan, QIAN Jihong   

  1. Department of Neonatal Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Received:2015-07-15 Online:2015-07-15 Published:2015-07-15

摘要: 目的 探讨影响出生胎龄≥34周新生儿呼吸衰竭短期预后的相关危险因素。方法 2011年1月至2013年6月选择新生儿重症监护室中143例出生胎龄≥34周的呼吸衰竭新生儿为研究对象,根据当次住院结局分为预后良好组和预后不良组;应用单因素分析及多因素二分类logistic回归模型,筛选呼吸衰竭不良预后的相关危险因素。结果 143例患儿中,预后良好组105例、预后不良组38例。单因素分析显示,分娩方式、小于胎龄儿、5分钟Apgar评分<7分和原发疾病为感染性肺炎/脓毒症与不良预后相关,差异有统计学意义(P均<0.05);将上述因素引入二分类logistic回归显示,小于胎龄儿(OR=23.87,95%CI:3.149~180.9)、感染性肺炎/脓毒症(OR=2.996,95%CI:1.514~5.928)是不良预后的独立危险因素。结论 小于胎龄儿、原发疾病为感染性肺炎/脓毒症是34周及以上胎龄新生儿呼吸衰竭不良预后的独立危险因素。

Abstract:  Objective To explore the risk factors for the prognosis of respiratory failure in neonates with gestational age ≥ 34 weeks. Methods A total of 143 hospitalized neonates with respiratory failure who had gestational age ≥ 34 weeks were enrolled from Jan. 2011 to Jun. 2013. According to the outcome, the neonates were divided into good prognosis group and poor prognosis group. The risk factors for the prognosis of respiratory failure were screened by univariate analysis and multivariate binary logistic regression model. Results Among the 143 neonates, 105 neonates had good prognosis and 38 neonates had poor prognosis. Univariate analysis showed that the mode of delivery, small for gestational age, 5 minutes Apgar score <7, and with primary disease being pneumonia/sepsis were associated with a poor prognosis. The differences were statistically significant (P<0.05). Furthermore, the multivariate binary logistic regression model showed that, small for gestation age (OR=23.87, 95% CI:3.149 - 180.9) and pneumonia/sepsis (OR=2.996, 95% CI:1.514 - 5.928) were the independent factors of poor prognosis. Conclusions Small for gestation age and primary diseases being pneumonia/sepsis are the independent factors influencing prognosis of respiratory failure in neonates born at a gestational age ≥ 34 weeks.