新生儿呼吸窘迫高危因素分析

摘要

目的 探讨新生儿呼吸窘迫发生的高危因素.方法 选择收治的所有出生后7d内需要接受插管机械通气或经鼻气道正压通气≥24 h的新生儿38例为病例组,同期入院的未发生呼吸窘迫的新生儿65例作为对照组,通过建立logistic回归模型,对新生儿呼吸窘迫可能的相关危险因素进行分析.结果 单因素分析显示胎龄、出生体重、低Apgar评分、高SNAP评分、低白蛋白血症、低球蛋白血症及高糖血症等与新生儿呼吸窘迫有关(均P ＜0.05).多因素logistic回归分析显示高SNAP评分(OR=1.25)、低白蛋白血症(OR=0.77)和高糖血症(OR=1.66)为新生儿呼吸窘迫的高危因素(均P＜0.01).结论 新生儿呼吸窘迫与高SNAP评分、低白蛋白血症和高糖血症等多因素有关,对这些高危因素的早期干预与治疗有助于降低新生儿呼吸窘迫的发生率.%Objective To determine the clinical risk factors associating with neonatal respiratory distress. Methods The study included 103 neonates admitted to neonatal intensive care unit (NICU), 38 neonates with mechanical ventilation or continuous positive airway pressure ≥24 h, and 65 without as controls. Serum and urine samples were collected and the score for neonatal acute physiology (SNAP), acting as a measure of illness severity, was calculated for each neonate based on 28 items collected over the first 24 h of admission. Results Multivariate logistic regression analysis identified higher SNAP score, lower serum albumin level, and higher serum glucose level as independent risk factors significantly associated with neonatal respiratory distress, which had odds ratio of 1.25, 0.77 and 1.66, respectively, for having respiratory distress in neonates. Conclusion SNAP and the serum levels of albumin and glucose correlate well with respiratory distress in critically ill neonates admitted to the NICU.