新生儿无创呼吸支持治疗并发消化道出血的影响因素分析(1)
【摘要】目的探讨新生儿无创呼吸支持治疗并发消化道出血的影响因素。
方法选择2017年10月至2019年4月收治的使用无创呼吸支持治疗的128例新生儿作为研究对象。将治疗期间并发消化道出血的30例新生儿纳入出血组，未并发消化道出血的98例新生儿纳入未出血组。对两组新生儿的临床资料进行单因素和多因素分析，找出新生儿无创呼吸支持治疗并发消化道出血的影响因素。
结果单因素结果表明：两组新生儿的胎龄、上机时间、出生体重、持续通气压力比较差异有统计学意义(P<0.05);多因素结果表明：胎龄<37周、上机时间≥4天、出生体重<1.5 kg、持续通气压力≥6 cmH2O是新生儿无创呼吸支持治疗并发消化道出血的危险因素(P<0.05)。
结论胎龄、上机时间、出生体重、持续通气压力是新生儿无创呼吸支持治療并发消化道出血的影响因素，无创呼吸支持治疗过程中需严格掌握好上机时间，并根据新生儿的具体临床体征给予合适的持续气道通气压力，以降低消化道出血的发生率。
【关键词】新生儿;无创呼吸;消化道出血;影响因素
中图分类号：R722.15+2文献标志码：ADOI：10.3969/j.issn.10031383.2020.06.012
【Abstract】ObjectiveTo investigate the influencing factors of complicated gastrointestinal bleeding after neonatal noninvasive respiratory support therapy.
MethodsA total of 128 newborns treated with noninvasive respiratory support therapy from October 2017 to April 2019 were selected as research subjects.30 newborns with gastrointestinal bleeding were included in the bleeding group，and 98 neonates without gastrointestinal bleeding during treatment were included in the nonbleeding group.Univariate and multivariate analysis were performed on the clinical data of the two groups of neonates to find out the influencing factors of gastrointestinal bleeding after noninvasive respiratory support treatment for neonatal bleeding.
ResultsThe single factor results indicated that there were statistically significant differences in gestational age，onset time，birth weight and continuous ventilation pressure between the two groups(P<0.05).Multifactor results indicated that gestational age<37 weeks，operation time≥4 days，birth weight<1.5 kg，continuous ventilation pressure≥6 cmH2O were risk factors for gastrointestinal bleeding during noninvasive respiratory support therapy(P<0.05).
ConclusionGestational age，operation time，birth weight and continuous ventilation pressure are the influencing factors of gastrointestinal bleeding during noninvasive respiratory support treatment.In the process of noninvasive respiratory support treatment，it is necessary to strictly control the time on the machine and give appropriate continuous airway ventilation pressure according to the specific clinical signs of the newborn，so as to reduce the incidence of gastrointestinal bleeding.
【Key words】newborn;noninvasive breathing;gastrointestinal bleeding;influencing factor
新生儿的呼吸系统发育不成熟，因此容易发生呼吸窘迫综合征、肺炎等呼吸系统疾病[1]，其临床症状包括呼吸困难、呼吸急促、呼吸暂停、口吐白沫等，若不及时治疗，会造成严重的后果[2]。呼吸系统疾病的治疗方法包括有创呼吸支持治疗和无创呼吸支持治疗，无创呼吸支持治疗越来越多地被运用于治疗新生儿呼吸系统疾病，在很多情况下可以取代有创呼吸支持[3]。无创呼吸支持治疗能使新生儿肺容量增大、肺泡通气时间延长、气管和鼻腔保持畅通、呼吸阻塞发生率降低[4]，且具有操作简单、安全、无创、临床效果显著等优点[5]。但同时，无创呼吸支持也会存在并发症，新生儿消化道出血是其中之一，新生儿消化道大量出血时会引起贫血、感染、休克等症状，严重危害新生儿的健康[6]。目前少见研究新生儿无创呼吸支持治疗并发消化道出血的影响因素。本研究对新生儿的临床资料进行单因素和多因素分析，找出新生儿无创呼吸支持治疗并发消化道出血的影响因素。, http://www.100md.com(陈源源 龚子龙 李幸鹤 姚艳桃)
方法选择2017年10月至2019年4月收治的使用无创呼吸支持治疗的128例新生儿作为研究对象。将治疗期间并发消化道出血的30例新生儿纳入出血组，未并发消化道出血的98例新生儿纳入未出血组。对两组新生儿的临床资料进行单因素和多因素分析，找出新生儿无创呼吸支持治疗并发消化道出血的影响因素。
结果单因素结果表明：两组新生儿的胎龄、上机时间、出生体重、持续通气压力比较差异有统计学意义(P<0.05);多因素结果表明：胎龄<37周、上机时间≥4天、出生体重<1.5 kg、持续通气压力≥6 cmH2O是新生儿无创呼吸支持治疗并发消化道出血的危险因素(P<0.05)。
结论胎龄、上机时间、出生体重、持续通气压力是新生儿无创呼吸支持治療并发消化道出血的影响因素，无创呼吸支持治疗过程中需严格掌握好上机时间，并根据新生儿的具体临床体征给予合适的持续气道通气压力，以降低消化道出血的发生率。
【关键词】新生儿;无创呼吸;消化道出血;影响因素
中图分类号：R722.15+2文献标志码：ADOI：10.3969/j.issn.10031383.2020.06.012
【Abstract】ObjectiveTo investigate the influencing factors of complicated gastrointestinal bleeding after neonatal noninvasive respiratory support therapy.
MethodsA total of 128 newborns treated with noninvasive respiratory support therapy from October 2017 to April 2019 were selected as research subjects.30 newborns with gastrointestinal bleeding were included in the bleeding group，and 98 neonates without gastrointestinal bleeding during treatment were included in the nonbleeding group.Univariate and multivariate analysis were performed on the clinical data of the two groups of neonates to find out the influencing factors of gastrointestinal bleeding after noninvasive respiratory support treatment for neonatal bleeding.
ResultsThe single factor results indicated that there were statistically significant differences in gestational age，onset time，birth weight and continuous ventilation pressure between the two groups(P<0.05).Multifactor results indicated that gestational age<37 weeks，operation time≥4 days，birth weight<1.5 kg，continuous ventilation pressure≥6 cmH2O were risk factors for gastrointestinal bleeding during noninvasive respiratory support therapy(P<0.05).
ConclusionGestational age，operation time，birth weight and continuous ventilation pressure are the influencing factors of gastrointestinal bleeding during noninvasive respiratory support treatment.In the process of noninvasive respiratory support treatment，it is necessary to strictly control the time on the machine and give appropriate continuous airway ventilation pressure according to the specific clinical signs of the newborn，so as to reduce the incidence of gastrointestinal bleeding.
【Key words】newborn;noninvasive breathing;gastrointestinal bleeding;influencing factor
新生儿的呼吸系统发育不成熟，因此容易发生呼吸窘迫综合征、肺炎等呼吸系统疾病[1]，其临床症状包括呼吸困难、呼吸急促、呼吸暂停、口吐白沫等，若不及时治疗，会造成严重的后果[2]。呼吸系统疾病的治疗方法包括有创呼吸支持治疗和无创呼吸支持治疗，无创呼吸支持治疗越来越多地被运用于治疗新生儿呼吸系统疾病，在很多情况下可以取代有创呼吸支持[3]。无创呼吸支持治疗能使新生儿肺容量增大、肺泡通气时间延长、气管和鼻腔保持畅通、呼吸阻塞发生率降低[4]，且具有操作简单、安全、无创、临床效果显著等优点[5]。但同时，无创呼吸支持也会存在并发症，新生儿消化道出血是其中之一，新生儿消化道大量出血时会引起贫血、感染、休克等症状，严重危害新生儿的健康[6]。目前少见研究新生儿无创呼吸支持治疗并发消化道出血的影响因素。本研究对新生儿的临床资料进行单因素和多因素分析，找出新生儿无创呼吸支持治疗并发消化道出血的影响因素。, http://www.100md.com(陈源源 龚子龙 李幸鹤 姚艳桃)