新生儿重症湿肺高危因素分析

目的 探讨新生儿重症湿肺的临床特征及需要机械辅助通气治疗的影响因素.方法 对167例新生儿湿肺进行回顾性分析,观察其临床特征、预后,分析需要机械辅助通气治疗的影响因素.结果 167例患儿中早产儿69例(41.2%).161例(96.4%)患儿入院时存在呼吸衰竭,72例(43.1%)需行气管插管机械通气.辅助通气组111例(气管插管72例,经鼻呼气末正压通气39例),非辅助通气组56例.两组患儿在年龄、出生体重、剖宫产率、性别比方面差异无显著性.全部患儿中24例合并心脏疾病,28例合并缺氧缺血性脑病,51例合并吸入性肺炎.湿肺患儿中胎龄<34周(OR=3.398,95%CI:1.113～10.369)及合并心脏疾病(OR=4.122,95%CI:1.173～14.481)者,需辅助通气的危险增加.是否有重度窒息、是否合并缺氧缺血性脑病及吸入性肺炎,未被证实是湿肺患儿需辅助通气的影响因素.结论 早产儿重症湿肺发生率较高,湿肺患儿胎龄<34周及合并心脏疾病时需要机械辅助通气的危险增加.

Analysis of high-risk factors for the neonates with wet lung

Objective To clarify the clinical features of serious wet lung of the newborn and to identify high-risk factors for needing mechanical ventilation(MV).Methods Retrospective study was performed on 167 newborn infants with serious wet lung at our NICU.Results There were 69 preterm infants(41.2%) in all of the neonates.96.4% of all the patients had respiratory failure when admitted.72 newborns(43.1%) needed intubation ventilation.There were 111 newborns in the mechanical ventilation group (included intubation ventilation and NCPAP),and 56 newborns in the non-mechanical ventilation group.There were no difference between two groups for their age,birth weight,cesarean section rate,and male sex.Of all the newborns,24 patients complicated with congenital heart disease,28 patients with hypoxic-ischemic encephalopathy(HIE),51 patients with aspirated pneumonia.Gestational age(GA)<34 weeks (OR=3.398,95%CI:1.113～10.369) and with congenital heart disease (OR=4.122,95%CI:1.173～14.481) were found to be highly associated with needing MV in the neonates with serious wet lung.Serious asphyxia,HIE,and aspirated pneumonia were not found to be risk factors for needing MV.Conclusion Serious wet lung is associated with significant morbidities in preterm newborn.GA<34 weeks and congenital heart disease are found to be risk factors for needing MV in neonates with serious wet lung.