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目的探讨早产儿动脉导管未闭(PDA)发生的危险因素及相关并发症。方法采用回顾性分析的方法,对2012年4月至2013年4月我院新生儿重症监护病房收治的PDA早产儿(观察组)和无PDA的早产儿(对照组)临床资料进行病例对照研究,在早产儿PDA暴露因素的单因素分析基础上,进行Logistic回归模型,分析早产儿PDA的危险因素及并发症。结果观察组96例,对照组170例,两组患儿一般资料差异无统计学意义(P>0.05)。单因素分析显示母亲妊娠期高血压、产前应用硫酸镁、宫内窘迫、胎盘病变、脐带异常、羊水减少、窒息、败血症、新生儿呼吸窘迫综合征、代谢性酸中毒、应用肺表面活性物质、呼吸支持及生后第1、2天液体入量与早产儿PDA相关联。并发症中脑室内出血、早产儿视网膜病、支气管肺发育不良与早产儿PDA相关联。多因素回归分析显示,呼吸支持(OR=0.868)、母亲产前应用硫酸镁(OR=0.247)是早产儿发生PDA的保护因素,败血症(OR=2.519)是早产儿发生PDA的独立危险因素。结论早期识别早产儿PDA的危险因素,积极预防和治疗PDA引起的并发症,对提高新生儿存活率及降低后遗症发生率有一定临床意义。
Objective To explore the risk factors and related complications of patent ductus arteriosus (PDA) in preterm infants. Methods A retrospective analysis of the clinical data from April 2012 to April 2013 in our hospital neonatal intensive care unit admitted to the PDA preterm children (observation group) and PDA-free preterm children (control group) case-control study Based on the single factor analysis of PDA exposure factors in preterm infants, Logistic regression model was used to analyze the risk factors and complications of PDA in premature infants. Results The observation group of 96 cases, control group of 170 cases, two groups of children with general data was no significant difference (P> 0.05). Univariate analysis showed that maternal hypertension in pregnancy, prenatal application of magnesium sulfate, intrauterine distress, placental lesions, umbilical cord abnormalities, amniotic fluid reduction, asphyxia, sepsis, neonatal respiratory distress syndrome, metabolic acidosis, pulmonary surfactant , Respiratory support and the first and second days after birth, fluid intake and PDA associated with premature children. Complications of intraventricular hemorrhage, retinopathy of prematurity, and bronchopulmonary dysplasia associated with PDA in preterm infants. Multivariate regression analysis showed that respiratory support (OR = 0.868), prenatal application of magnesium sulfate (OR = 0.247) was a protective factor for PDA in preterm infants, and sepsis (OR = 2.519) was an independent risk factor for PDA in preterm infants. Conclusion Early identification of risk factors for preterm children PDA, and active prevention and treatment of complications caused by PDA, to improve neonatal survival and reduce the incidence of sequelae have some clinical significance.