生后早期需要有创机械通气早产儿发生呼吸衰竭的高危因素逻辑回归分析

Logistic Regression Analysis of High Risk Factors of Respiratory Failure in Premature Infants Requiring Invasive Mechanical Ventilation in Early Postnatal Period

摘要: 目的：分析生后早期(≤72 h)需要有创机械通气治疗的早产儿发生呼吸衰竭的高危因素。方法：回顾性分析2018年1月1日至2024年6月30日期间生后早期需要有创机械通气治疗的早产儿的临床资料，通过Logistic回归分析，得到影响生后早期进行有创机械通气早产儿呼吸衰竭发生率的危险因素。结果：在单因素分析结果中，胎龄、出生后10分钟Apgar评分、胎盘异常情况、母亲孕期阴道流血、败血症、休克、肺出血、吸入NO治疗，使用PS次数、使用升血压药物、住院期间总有创通气时间共11个自变量有统计学差异；多因素分析结果显示出生后10分钟Apgar评分、败血症、母亲分娩前阴道流血、肺出血、使用PS次数、使用升血压药物为生后早期需要有创机械通气治疗的早产儿发生呼吸衰竭的独立影响因素。结论：本研究发现母亲分娩前阴道流血、出生后低10分钟Apgar评分、败血症、肺出血、生后多次使用PS次数、使用升血压药物为与生后早期需要有创机械通气治疗的早产儿呼吸衰竭的发生率有关，为临床医师在早产儿呼吸衰竭的诊治方面提供更为全面的参考。

Abstract: Objective: To analyze the high risk factors of respiratory failure in premature infants requiring invasive mechanical ventilation in the early postnatal period. Methods: Clinical data of premature infants requiring invasive mechanical ventilation in the early postnatal period from January 1, 2018 to June 30, 2024 were retrospectively analyzed. Logistic regression analysis was used to obtain risk factors affecting the incidence of respiratory failure in premature infants receiving invasive mechanical ventilation in the early postnatal period. Results: In univariate analysis, there were significant differences in 11 variables including gestational age, Apgar score at 10 minutes after birth, placenta abnormality, vaginal bleeding during pregnancy, sepsis, shock, pulmonary hemorrhage, inhaled NO therapy, PS frequency, use of blood pressure-raising drugs and total invasive ventilation time during hospitalization. Multivariate analysis showed that Apgar score at 10 minutes after birth, sepsis, maternal vaginal bleeding before delivery, pulmonary hemorrhage, PS frequency, and use of blood pressure-raising drugs were independent risk factors for respiratory failure in premature infants requiring invasive mechanical ventilation early after birth. Conclusion: This study found that maternal vaginal bleeding before delivery, low Apgar score 10 minutes after birth, sepsis, pulmonary hemorrhage, multiple use of PS after birth, and use of blood pressure-raising drugs were associated with the incidence of respiratory failure in premature infants requiring invasive mechanical ventilation in the early postnatal period. It provides a more comprehensive reference for clinicians in the diagnosis and treatment of respiratory failure in premature infants.