早产儿呼吸暂停高危因素的临床研究

发布时间：2017-12-31 00:39

本文关键词：早产儿呼吸暂停高危因素的临床研究　出处：《泰山医学院》2013年硕士论文　论文类型：学位论文

【摘要】：目的探讨导致早产儿呼吸暂停（Apnea of premature, AOP）发作的常见因素，分析最终引起该病的危险因素，对其高度重视，提前预防及采取措施，提高防治水平，减少或避免并发症。方法收集中国人民解放军第88医院新生儿科2011年1月～2012年12月及中国人民解放军八一儿童医院2012年3月～6月收治的呼吸暂停早产儿103例，及同期住院的非呼吸暂停早产儿103例作为临床资料。呼吸暂停组为病例组，非呼吸暂停为对照组。对患儿的胎龄、出生体重等22种因素进行回顾性分析，然后予以统计学处理。结果 1.本研究103例AOP患儿，，原发性呼吸暂停40例，发生率为38.8%，继发性呼吸暂停63例，发生率为61.2%。呼吸暂停在病程早期发生率较高，其中12小时内AOP共47例，发生率为45.63%；12小时～2天AOP共36例，发生率为35%；2天～5天AOP共12例，占11.7%，原发性呼吸暂停5天内发生率较高，继发性呼吸暂停可发生在病程任何阶段。 2.出生体重越小，胎龄越小，呼吸暂停发生率越高，尤其是原发性呼吸暂停，继发性呼吸暂停发生率较原发性呼吸暂停低。AOP组中，感染性疾病共28例，发生率为27.2%，早产儿中枢神经系统疾病共41例，发生率为39.8%；新生儿呼吸窘迫综合征（Neonatal respiratory distress syndrome, NRDS）21例，发生率为13.1%，代谢性紊乱50例，占48.5%。 3.通过对两组103例AOP及非AOP分析，22种因素进行组间比较：胎龄小于33周、出生体重＜1500克、新生儿肺炎、酸中毒、呼吸窘迫综合征、颅内出血、贫血、缺氧缺血性脑病（Hypoxic ischemic encephalopathy, HIE）、胎粪吸入综合征、低钙血症共8种高危因素，P值＜0.05。 4.经高危因素的单因素Logistic回归分析：胎龄小于33周、出生体重＜1500克、酸中毒是AOP的高危因素。P值均小于0.05。结论 1.呼吸暂停与出生体重、胎龄有关：出生体重越小，胎龄越小，呼吸暂停发生率越高，而且原发性呼吸暂停发生率亦越高，继发性呼吸暂停随体重胎龄变化无明显规律。 2.呼吸暂停与出生后时间有关：呼吸暂停病程早期发生率较高，原发性呼吸暂停5天内发生率较高，继发性呼吸暂停可发生在病程任何阶段。 3.胎龄小于33周、出生体重＜1500克、酸中毒是早产儿AOP发病的独立高危因素。
[Abstract]:Purpose To investigate the common factors leading to apnea of apnea of preterm infants (AOPs), and to analyze the risk factors leading to the disease, and to attach great importance to it. Preventive measures should be taken in advance to improve the level of prevention and treatment and to reduce or avoid complications. Method The paediatrics of the 88th Hospital of the Chinese people's Liberation Army (PLA) from January 2011 to December 2012 and the Bayi Children's Hospital of the Chinese people's Liberation Army (PLA) from March 2012 to March 2012 were collected. 03 cases. The clinical data were 103 cases of non-apnea premature infants in the same period. The apnea group was the case group and the non-apnea group was the control group. 22 factors, such as gestational age, birth weight and so on, were analyzed retrospectively. They are then treated statistically. Results 1. There were 40 patients with primary apnea (38.8%) and 63 cases with secondary apnea (63 cases) in this study. The incidence of apnea was higher in the early stage of the disease, including 47 cases of AOP within 12 hours (45.63%). There were 36 cases of AOP in 12 hours and 2 days, the incidence rate was 35%. There were 12 cases of AOP in 2 days and 5 days, accounting for 11. 7%. The incidence of primary apnea was higher within 5 days. Secondary apnea could occur at any stage of the course of disease. 2. The lower the birth weight and the smaller the gestational age, the higher the incidence of apnea, especially in the primary apnea group, the secondary apnea rate was lower than that in the primary apnea group. There were 28 cases of infectious diseases, the incidence rate was 27.2%, and 41 cases of central nervous system diseases of premature infants, the incidence rate was 39.8%. The incidence of Neonatal respiratory distress syndrome (NRDS)21) was 13.1%. Metabolic disorders were found in 50 cases (48.5%). 3. 22 factors of AOP and non AOP analysis were compared between the two groups: gestational age was less than 33 weeks, birth weight was less than 1500g, neonatal pneumonia, acidosis. Respiratory distress syndrome, intracranial hemorrhage, anemia, Hypoxic ischemic encephalopathy, HIE, meconium aspiration syndrome. There were 8 high risk factors in hypocalcemia (P < 0.05). 4. Univariate Logistic regression analysis of high risk factors: gestational age < 33 weeks, birth weight < 1500g, acidosis is the high risk factor of AOP, P < 0.05. Conclusion 1. Apnea is related to birth weight and gestational age: the smaller the birth weight, the smaller the gestational age, the higher the incidence of apnea and the higher the incidence of primary apnea. There was no obvious change of secondary apnea with body weight and gestational age. 2.Respiratory apnea is related to postnatal time: the incidence of early stage of apnea is higher than that of primary apnea within 5 days. Secondary apnea can occur at any stage of the disease course. 3. Gestational age < 33 weeks, birth weight < 1500g, acidosis is an independent risk factor for preterm infants with AOP.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R722.6

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