Background Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs).However,the risk factors for PH are controversial.Therefore,the purpose of this study ...Background Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs).However,the risk factors for PH are controversial.Therefore,the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs.Methods This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g,lived for at least 12 hours,and did not have major congenital anomalies.A logistic regression model was established to analyze the risk factors associated with PH.Results There were 168 ELBWIs born during this period.A total of 160 infants were included,and 30 infants were diagnosed with PH.Risk factors including gestational age,small for gestational age,intubation in the delivery room,surfactant in the delivery room,repeated use of surfactant,higher FiO2 during the first day,invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis.In the logistic regression model,EOS was found to be an independent risk factor for PH.The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH.The rates of periventricular leukomalacia,moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity,and the duration of the hospital stay were not significantly different between the PH and no-PH groups.Conclusions Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia,it increased the mortality and intraventricular hemorrhage rate in ELBWIs.EOS was the independent risk factor for PH in ELBWIs.展开更多
目的系统分析我国极低体重儿(VLBWI)和超低出生体重儿(ELBWI)颅内出血(ICH)的危险因素,为早期预防和临床决策提供参考依据。方法通过计算机检索了建库至2020年9月18日在中国知网、中国生物医学文献数据库(CBM)、万方数据库、VIP数据库、...目的系统分析我国极低体重儿(VLBWI)和超低出生体重儿(ELBWI)颅内出血(ICH)的危险因素,为早期预防和临床决策提供参考依据。方法通过计算机检索了建库至2020年9月18日在中国知网、中国生物医学文献数据库(CBM)、万方数据库、VIP数据库、Cochrane图书馆、PubMed、Web of Science、EMBASE等数据库发表的文献,并手动检索相关参考文献。按照文献的纳入和排除标准,纳入较高质量文献,最后采用RevMan5.3对其进行Meta分析。结果13篇文献符合纳入标准,累计ICH人数790例,无ICH人数1871例,经Meta分析结果显示,VLBWI和ELBWI颅内出血的危险因素为:宫内窘迫或窒息(OR=2.52,95%CI:1.98~3.21)、应用机械通气(OR=3.35,95%CI:2.56~4.38)、机械通气时间>3d(OR=10.29,95%CI:3.69~28.66)、凝血机制障碍(OR=3.42,95%CI:1.80~6.48),新生儿坏死性小肠结肠炎(OR=3.79,95%CI:1.92~7.50),胎龄<29周(OR=2.45,95%CI:1.65~3.64),保护因素为产前应用糖皮质激素(OR=0.35,95%CI:0.22~0.56)。经阴道分娩在本研究结果中无统计学意义。结论宫内窘迫或窒息、应用机械通气、机械通气时间>3d、凝血机制障碍、新生儿坏死性小肠结肠炎、胎龄<29周等因素与VLBWI和ELBWI颅内出血关系密切,产前应用糖皮质激素可以降低VLBWI和ELBWI颅内出血的发生率。展开更多
目的探讨影响超高龄（≥80岁）脑出血患者预后的相关因素。方法回顾性分析2010年6月-2013年6月收治的104例超高龄脑出血患者的临床资料。根据格拉斯哥预后评分,将患者分为预后良好组（4-5分）和预后不良组（1-3分）。对两组的性别、年...目的探讨影响超高龄（≥80岁）脑出血患者预后的相关因素。方法回顾性分析2010年6月-2013年6月收治的104例超高龄脑出血患者的临床资料。根据格拉斯哥预后评分,将患者分为预后良好组（4-5分）和预后不良组（1-3分）。对两组的性别、年龄、入院时意识、入院时平均动脉压、收缩压及并发症发生率进行比较。结果预后良好组62例,预后不良组42例;两组在性别、年龄、入院时平均动脉压方面相差无统计学意义（P〉0.05）。预后良好组入院时意识评分为（13.79±2.38）分,高于预后不良组[（8.24±3.80）分],差异有统计学意义（P〈0.05）;预后良好组并发症发生率（45.2%）、入院时收缩压[（168.87±25.03）mm Hg（1 mm Hg=0.133 k Pa）]均低于预后不良组[88.1%,（181.83±29.82）mm Hg],差异均有统计学意义（P〈0.05）。结论对于超高龄脑出血患者,意识、入院时收缩压、并发症发生率是其预后的影响因素。此外,入院时收缩压〉180 mm Hg可能是超高龄患者预后不良的因素之一。展开更多
文摘Background Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs).However,the risk factors for PH are controversial.Therefore,the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs.Methods This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g,lived for at least 12 hours,and did not have major congenital anomalies.A logistic regression model was established to analyze the risk factors associated with PH.Results There were 168 ELBWIs born during this period.A total of 160 infants were included,and 30 infants were diagnosed with PH.Risk factors including gestational age,small for gestational age,intubation in the delivery room,surfactant in the delivery room,repeated use of surfactant,higher FiO2 during the first day,invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis.In the logistic regression model,EOS was found to be an independent risk factor for PH.The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH.The rates of periventricular leukomalacia,moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity,and the duration of the hospital stay were not significantly different between the PH and no-PH groups.Conclusions Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia,it increased the mortality and intraventricular hemorrhage rate in ELBWIs.EOS was the independent risk factor for PH in ELBWIs.
文摘目的系统分析我国极低体重儿(VLBWI)和超低出生体重儿(ELBWI)颅内出血(ICH)的危险因素,为早期预防和临床决策提供参考依据。方法通过计算机检索了建库至2020年9月18日在中国知网、中国生物医学文献数据库(CBM)、万方数据库、VIP数据库、Cochrane图书馆、PubMed、Web of Science、EMBASE等数据库发表的文献,并手动检索相关参考文献。按照文献的纳入和排除标准,纳入较高质量文献,最后采用RevMan5.3对其进行Meta分析。结果13篇文献符合纳入标准,累计ICH人数790例,无ICH人数1871例,经Meta分析结果显示,VLBWI和ELBWI颅内出血的危险因素为:宫内窘迫或窒息(OR=2.52,95%CI:1.98~3.21)、应用机械通气(OR=3.35,95%CI:2.56~4.38)、机械通气时间>3d(OR=10.29,95%CI:3.69~28.66)、凝血机制障碍(OR=3.42,95%CI:1.80~6.48),新生儿坏死性小肠结肠炎(OR=3.79,95%CI:1.92~7.50),胎龄<29周(OR=2.45,95%CI:1.65~3.64),保护因素为产前应用糖皮质激素(OR=0.35,95%CI:0.22~0.56)。经阴道分娩在本研究结果中无统计学意义。结论宫内窘迫或窒息、应用机械通气、机械通气时间>3d、凝血机制障碍、新生儿坏死性小肠结肠炎、胎龄<29周等因素与VLBWI和ELBWI颅内出血关系密切,产前应用糖皮质激素可以降低VLBWI和ELBWI颅内出血的发生率。
文摘目的探讨影响超高龄（≥80岁）脑出血患者预后的相关因素。方法回顾性分析2010年6月-2013年6月收治的104例超高龄脑出血患者的临床资料。根据格拉斯哥预后评分,将患者分为预后良好组（4-5分）和预后不良组（1-3分）。对两组的性别、年龄、入院时意识、入院时平均动脉压、收缩压及并发症发生率进行比较。结果预后良好组62例,预后不良组42例;两组在性别、年龄、入院时平均动脉压方面相差无统计学意义（P〉0.05）。预后良好组入院时意识评分为（13.79±2.38）分,高于预后不良组[（8.24±3.80）分],差异有统计学意义（P〈0.05）;预后良好组并发症发生率（45.2%）、入院时收缩压[（168.87±25.03）mm Hg（1 mm Hg=0.133 k Pa）]均低于预后不良组[88.1%,（181.83±29.82）mm Hg],差异均有统计学意义（P〈0.05）。结论对于超高龄脑出血患者,意识、入院时收缩压、并发症发生率是其预后的影响因素。此外,入院时收缩压〉180 mm Hg可能是超高龄患者预后不良的因素之一。
