摘要
目的探讨新生儿肺出血预后危险因素。方法选择浙江省台州恩泽医疗集团恩泽医院及台州医院新生儿科2010年1月至2016年12月新生儿肺出血患儿120例作为肺出血组,同期住院的非肺出血新生儿120例作为对照组;依据肺出血患儿的预后,将肺出血患儿分为存活组和死亡组,分别收集两组新生儿临床资料和血小板参数进行分析。结果肺出血组血小板计数低于对照组(t=21.425,P<0.05)、血小板体积分布宽度(PDW)高于对照组(t=16.425,P<0.05),肺出血组与对照组血小板压积(PCT)和平均血小板体积(MPV)差异均无统计学意义(t值分别为1.352、0.867,均P>0.05)。单因素分析结果显示:新生儿窒息、循环衰竭、硬肿症、高钾血症、弥漫性血管内凝血、血小板减少症、MPV与新生儿肺出血的预后有关(χ~2值分别为7.843、4.936、5.446、3.951、16.688、5.973、18.100,均P<0.05),性别、胎龄、胎数、分娩方式、母亲妊娠期高血压疾病、前置胎盘、胎膜早破、胎盘早剥、呼吸衰竭、呼吸窘迫综合征、肺炎、低血糖、酸中毒、凝血功能障碍、低钙血症、低钠血症、PDW、PCT与新生儿肺出血的预后无关(均P>0.05)。多元非条件Logistic回归分析结果显示:新生儿窒息、硬肿症、高钾血症、弥漫性血管内凝血、MPV是新生儿肺出血预后的独立危险因素(Waldχ~2=5.314~6.427,均P<0.05)。结论新生儿肺出血与血小板计数及PDW有关,新生儿窒息、硬肿症、高钾血症、弥漫性血管内凝血、MPV是新生儿肺出血预后的独立危险因素。
Objective To investigate the risk factors in prognosis of neonatal pulmonary hemorrhage（NPH）.Methods Totally 120 cases of NPH selected from department of neonatology of Enze Hospital of Taizhou Enze Medical Group and Taizhou Hospital in Zhejiang Province were recruited in pulmonary hemorrhage group,and 120 cases without pulmonary hemorrhage who were hospitalized were selected in control group from January 2010 to December 2016.The neonates were divided into survival group and death group according to prognosis.The clinical data and platelet parameters of two groups were compared.Results The platelet counts of the pulmonary hemorrhage group was lower than that of the control group（t=21.425,P〈0.05）,but the platelet volume distribution width（PDW）was higher（t=16.425,P〈0.05）.There were no significant differences in platelet specific volume（PCT）and mean platelet volume（MPV）between the pulmonary hemorrhage group and the control group（t value was1.352 and 0.867,respectively,both P〈0.05）.Single factor analysis showed that neonatal asphyxia,circulatory failure,scleredema,hyperkalemia,disseminated intravascular coagulation（DIC）,thrombocytopenia and MPV were associated with NPH（χ~2 value was 7.843,4.936,5.446,3.951,16.688,5.973 and 18.100,respectively,all P〈0.05）,but sex,gestational age,number of fetuses,mode of delivery,maternal hypertensive disorder,placenta previa,premature rupture of membrane,placental abruption,respiratory failure,respiratory distress syndrome,pneumonia,hypoglycemia,acidosis,coagulation dysfunction,hypocalcemia,hyponatremia,PDW and PCT were not associated with NPH（all P〈0.05）.Multivariate non-conditional Logistic regression analysis showed that neonatal asphyxia,scleredema,hyperkalemia,DIC and MPV were independent risk factors for NPH（Waldχ~2 value ranged 5.314-6.427,all P〈0.05）.Conclusion NPH is related to platelet count and PDW.Neonatal asphyxia,scleredema,hyperkalemia,disseminated intravascular coagulation and MPV are independent risk factors
作者
叶梅玲
周彩玲
王灵华
王丽珍
罗群燕
YE Mei-ling;ZHOU Cai-ling;WANG Ling-hua;WANG Li-zhen;LUO Qun-yan(Department of Neonatology,Enze Hospital,Taizhou Enze Medical Group,Zhejiang Taizhou 318000,China;Department of Neonatology,Taizhou Hospital,Zhejiang Taizhou 318000,China)
出处
《中国妇幼健康研究》
2018年第8期962-965,共4页
Chinese Journal of Woman and Child Health Research
关键词
新生儿
肺出血
平均血小板体积
血小板体积分布宽度
neonates
pulmonary hemorrhage
average platelet volume （MPV）
platelet volume distribution width （PDW）
