目的 探讨影响新生儿肺出血预后的相关因素。方法 选择2005年1月至2011年12月住院治疗的69例确诊为肺出血的新生儿为研究对象,根据临床预后分为死亡组和存活组,对两组患儿的临床特征进行单因素分析,筛选出关联因素,并以此为基础,进行非条件Logistic多元回归模型分析。结果 单因素分析表明,新生儿肺出血死亡与吸入性肺炎、高胆红素血症、弥漫性血管内凝血、心力衰竭及血小板平均体积(MPV)相关联。多元回归模型提示患儿有弥漫性血管内凝血(OR=6.90,95%CI:1.51~31.42)和心力衰竭(OR=9.62,95%CI:1.71~54.15),以及肺出血前MPV<11 fl(OR=7.01,95%CI:1.48~33.31),是肺出血死亡的独立危险因素。结论 对并存弥漫性血管内凝血、心力衰竭及MPV值低的新生儿肺出血应采取更积极的干预措施。
Objective??To investigate the risk factors in the outcome of neonatal pulmonary hemorrhage. Methods A total of 69 cases of neonatal pulmonary hemorrhage from January 2005 to December 2011 were studied. They were divided into 2 groups according to clinical outcome (death or alive). The data of the two groups were compared using single factor analysis. The risk factors were analyzed using multi-factor analysis. Results The death of neonates with pulmonary hemorrhage was correlated with aspiration pneumonia, coagulation abnormalities, DIC, heart failure and MPV. Multi-factor analysis showed that DIC (OR=6.90, 95%CI: 1.514-31.419), heart failure (OR=9.62, 95%CI: 1.710-54.150) and MPV <11 prior to pulmonary hemorrhage (OR=7.01, 95%CI: 1.475-33.312) were the independent risk factors of neonatal pulmonary hemorrhage. Conclusions For the neonatal pulmonary hemorrhage with DIC, heart failure and low MPV, active intervention should be implemented.