34周及以上胎龄新生儿呼吸衰竭预后分析

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。%ObjectiveTo explore the risk factors for the prognosis of respiratory failure in neonates with gestational age≥34 weeks. MethodsA 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 mul-tivariate binary logistic regression model.ResultsAmong 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 signif-icant (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. ConclusionsSmall for gestation age and primary diseases being pneumonia/sepsis are the independent factors inlfuencing prog-nosis of respiratory failure in neonates born at a gestational age≥34 weeks.