CAJ | 학술논문

目的：探讨早产儿肺出血的危险因素。方法将苏北人民医院新生儿科2004年1月至2014年8月确诊为早产儿肺出血的病例作为病例组，按1∶2的比例随机选取同期入住我科的非肺出血并治愈出院的早产儿作为对照组，采用Logistic回归法对肺出血危险因素进行分析。结果病例组32例，对照组64例，通过单因素分析发现，应用肺表面活性物质（PS）、起病前有机械通气史、窒息复苏史、低钠血症、酸中毒、血小板减少、白细胞异常、胎龄、出生体重共9项与肺出血的联系有统计学意义（P＜0.05）；Logistic回归分析显示，酸中毒（OR＝22.487）、血小板减低（OR＝16.972）、白细胞异常（OR＝4.574）、PS的应用（OR＝0.011）、胎龄（OR＝0.075）及出生体重（OR＝0.131）与肺出血的关联有统计学意义。结论酸中毒、血小板减低、白细胞异常是肺出血的危险因素，PS的应用、胎龄和出生体重则可能是肺出血的保护因素。在治疗基础疾病的同时，密切监测血气、血常规等指标变化，对早期发现早产儿肺出血和提高其救治成功率具有一定的指导价值。
목적：탐토조산인폐출혈적위험인소。방법장소북인민의원신생인과2004년1월지2014년8월학진위조산인폐출혈적병례작위병례조，안1∶2적비례수궤선취동기입주아과적비폐출혈병치유출원적조산인작위대조조，채용Logistic회귀법대폐출혈위험인소진행분석。결과병례조32례，대조조64례，통과단인소분석발현，응용폐표면활성물질（PS）、기병전유궤계통기사、질식복소사、저납혈증、산중독、혈소판감소、백세포이상、태령、출생체중공9항여폐출혈적련계유통계학의의（P＜0.05）；Logistic회귀분석현시，산중독（OR＝22.487）、혈소판감저（OR＝16.972）、백세포이상（OR＝4.574）、PS적응용（OR＝0.011）、태령（OR＝0.075）급출생체중（OR＝0.131）여폐출혈적관련유통계학의의。결론산중독、혈소판감저、백세포이상시폐출혈적위험인소，PS적응용、태령화출생체중칙가능시폐출혈적보호인소。재치료기출질병적동시，밀절감측혈기、혈상규등지표변화，대조기발현조산인폐출혈화제고기구치성공솔구유일정적지도개치。
ObjectiveTo investigate the risk factors of pulmonary hemorrhage in preterms. Methods A retrospective case-control study including all preterms hospitalized with pulmonary hemorrhage from January 2004 to August 2014 and preterm controls in the corresponding time period according to the proportion of 1∶2 were carried out to analyze the multivariable risk factors of the pulmonary hemorrhage with Logistic regression.Results Of all the cases, the pulmonary hemorrhage group included 32 cases and the control group included 64. Single factor analysis demonstrated that using the pulmonary surfactant, mechanical ventilator therapy history, asphyxia recovery history, acidosis, hyponatremia, platelet reduction, abnormal white blood cell count, gestational age and birth weight were statistically associated with the onset of pulmonary hemorrhage. Multivariable analysis of the logistic regression demonstrated that acidosis(OR=22.487, 95%CI=4.132-122.378), platelet reduction(OR=16.972, 95%CI=1.719-167.512), abnormal white blood cell count(OR=4.574, 95%CI=1.089-19.219), using the pulmonary surfactant(OR=0.011, 95%CI=0.000-0.474), gestational age(OR=0.075, 95%CI=0.011-0.518) and birth weight(OR=0.131, 95%CI=0.024-0.713) were the 6 factors having statistical significance to the pulmonary hemorrhage of the preterms. Conclusion In this study, acidosis, platelet reduction, abnormal white blood cell count were risk factors of the pulmonary hemorrhage of the preterms while using the pulmonary surfactant, gestational age and birth weight may be protective factors. Detecting common indicators like blood routine and blood gas analysis during hospitalization may have a certain guiding value in detecting and rescuing the risks at the early stage.