晚期早产儿RDS机械通气并发症相关因素分析

目的分析晚期早产儿呼吸窘迫综合征（RDS）机械通气并发症相关影响因素。方法收集新生儿重症监护室（NICU）机械通气RDS晚期早产儿60例,根据是否发生机械通气并发症分为无并发症组（42例）和并发症组（18例）,比较两组病儿基本情况、围生期因素、孕母基本情况、机械通气情况的差异,采用Logistic回归方法对影响因素进行多元回归分析。结果两组病儿呼吸窘迫评分、新生儿危重病例评分、未足月胎膜早破发生率、肺表面活性物质（PS）使用率、机械通气前动脉血pH值、机械通气前动脉肺泡氧分压比值（a/A PO2）、母亲年龄方面比较差异有显著性（t或χ2=-2.371-5.080,P〈0.05）;Logistic回归分析显示,呼吸窘迫评分、新生儿危重病例评分、机械通气前a/A PO2、机械通气前动脉血pH值、未足月胎膜早破对并发症发生有一定影响（OR=0.017-9.503E36）。结论 RDS晚期早产儿机械通气并发症发生与多种因素有关。其中呼吸窘迫评分、新生儿危重病例评分、未足月胎膜早破、机械通气前a/A PO2及动脉血pH值与并发症发生密切相关。

ANALYSIS OF COMPLICATION-RELATED FACTORS OF MECHANICAL VENTILATION IN LATE PRETERM INFANTS WITH RESPIRATORY DISTRESS SYNDROME

Objective To analyze the complication-related factors of mechanical ventilation in late preterm infants（LPIs）with respiratory distress syndrome（RDS）. Methods Data of 60 LPIs with RDS were collected from neonatal intensive care unit（NICU）.The LPIs were divided into complication group（42cases）and no complication group（18cases）according to with or without mechanical ventilation complications.The differences between the two groups were compared in terms of general status of the infants and mothers,perinatal factors and mechanical ventilation.Logistic regression was applied to analyze the influencing factors. Results The differences between complication and no complication groups were significant in term of the following items：respiratory distress score,neonatal critical illness score,the incidence of preterm premature rupture of the membrane,utilization of pulmonary surfactant（PS）,the value of arterial pH and arterial alveolar oxygen partial pressure ratio（a/A PO2）before mechanical ventilation and maternal age（t orχ2=-2.371-5.080,P〈0.05）.Logistic regression analysis indicated that the complications were related to respiratory distress score,neonatal critical illness score,preterm premature rupture of membranes,a/A PO2 and arterial pH before mechanical ventilation（OR=0.017-9.503E36）. Conclusion The complications of late preterm infants with RDS are related with varied factors,of which,respiratory distress score,neonatal critical illness score,preterm premature rupture of the membrane,a/A PO2 and arterial pH are closely correlated.