低出生体重儿发生肺出血危险因素的临床分析

Clinical Analysis of Risk Factors for Pulmonary Hemorrhage in Low Birth Weight Infants

摘要: 目的：探讨低出生体重儿(LBWIs)发生肺出血(PH)的危险因素，以期提高对新生儿肺出血的认识。方法：回顾性分析2020年6月~2022年12月入住新生儿重症监护病房的131例LBWIs发生PH的患儿作为肺出血组，随机选取同期住院且未发生PH的131例LBWIs作为非肺出血组，单因素及多因素logistic回归分析其危险因素。结果：1) 出生体重儿发生肺出血与其胎龄、出生体重、1 min Apgar评分、孕母产前使用抗生素、妊娠期高血压疾病、有创呼吸机时长、使用肺表面活性物质、合并肺发育不良，呼吸窘迫综合征、新生儿败血症、凝血功能障碍、新生儿休克、重症肺炎合并呼吸衰竭、新生儿窒息、动脉导管未闭、重度肺动脉高压等的联系有统计学意义(P < 0.05)。2) 孕母产前使用抗生素可能为保护因素(OR = 0.249，P < 0.05)，而较长时间使用有创呼吸机辅助通气、重症肺炎合并呼吸衰竭、重度肺动脉高压为危险因素(OR = 1.153、4.377和3.849，均P < 0.05)。结论：LBWIs发生PH为多因素作用结果，掌握其高危因素，采取针对性措施，以便早期诊断，及时治疗，从而提高救治率。

Abstract: Objective: To explore the risk factors for pulmonary hemorrhage (PH) in low birth weight infants (LBWIs) and improve the understanding of neonatal pulmonary hemorrhage. Methods: Retrospec-tive analysis of clinical data of 131 cases of LBWIs admitted to the Neonatology Department of Chongqing Medical University Affiliated Children’s Hospital from June 2020 to December 2022, who developed PH, was selected as the pulmonary hemorrhage group. Randomly selected 131 cases of LBWIs admitted during the same period who did not develop PH were selected as the non-pulmonary hemorrhage group. Univariate and multivariate logistic regression analyses were conducted to analyze the risk factors. Results: 1) The occurrence of pulmonary hemorrhage in LBWIs was significantly associated with gestational age, birth weight, 1 min Apgar score, maternal use of antibiotics during pregnancy, hypertensive disorder complicating pregnancy, duration of in-vasive mechanical ventilation, use of pulmonary surfactant, bronchopulmonary dysplasia, respira-tory distress syndrome, neonatal sepsis, coagulation disorders, neonatal shock, severe pneumonia with respiratory failure, neonatal asphyxia, and patent ductus arteriosus (P < 0.05). 2) The mater-nal use of antibiotics during pregnancy may be a protective factor (OR = 0.249, P < 0.05), while pro-longed duration of invasive mechanical ventilation, severe pneumonia with respiratory failure, and severe pulmonary hypertension were identified as risk factors (OR = 1.153, 4.377, and 3.849, re-spectively, all P < 0.05). Conclusion: The occurrence of PH in LBWIs is the result of multiple factors. By identifying high-risk factors and implementing targeted measures, early diagnosis and timely treatment can be achieved, thereby improving the survival rate.