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    • 早产儿动脉导管未闭的危险因素及相关并发症分析

    孙玄,陈玲,高金枝,周建华,胡晓琳

    Chinese Journal of Reproductive Health（2021）

    Cited 4|Views26
    Abstract
    目的 探讨1044例早产儿动脉导管未闭(PDA)的发生率、危险因素及相关并发症的发生情况.方法 选择2016年5月-2019年4月华中科技大学同济医学院附属同济医院新生儿科收治的早产儿(胎龄<34周)作为研究对象,根据生后一周内超声心动图结果分为PDA组(249例)和对照组(795例),收集两组早产儿的临床资料进行病例对照研究,对PDA发生的相关因素进行单因素分析,并建立二元Logistic回归模型,分析PDA的危险因素及相关并发症的发生情况.结果 胎龄小于34周早产儿PDA发生率为23.9％.且胎龄和出生体重越小,PDA发生率越高.单因素分析结果显示,胎龄、出生体重、窒息、妊娠高血压、产前糖皮质激素使用、胎膜早破与PDA的发生有关(P<0.05).多因素二元Logistic回归分析显示,胎龄小(OR=1.40,95％CI:1.24～1.59)、窒息(OR=1.82,95％CI:1.21～2.75)是PDA发生的独立危险因素;胎膜早破(OR=0.63,95％CI:0.45～0.88)、产前糖皮质激素使用(OR=0.52,95％CI:0.36～0.76)是PDA的独立保护因素.PDA组患儿有创及无创呼吸机应用、肺炎、早产儿支气管肺发育不良(BPD)、喂养不耐受、Bell分期Ⅱ期以上坏死性小肠结肠炎(NEC)、颅内出血(IVH)、早产儿视网膜病变(ROP)及肾损伤的发生率高于对照组,差异有统计学意义,两组患儿在脑室周围白质软化(PVL)的发生率之间的差异无统计学意义.结论 早产儿胎龄和出生体重越小,PDA发生率越高;胎龄小和窒息是早产儿PDA的高危因素之一,而产前激素使用和胎膜早破是其保护因素.早产儿PDA可引起呼吸机应用时间延长,增加肺炎、BPD、喂养不耐受、NEC、IVH、ROP及肾损伤的发生率.
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