Analysis Of Clinical Risk Factors In Neonatal Pulmonary Hemorrhage

Object: In order to determine the high-risk factors in neonatal pulmonary hemorrhage(NPH) and corresponding diagnosis/treatment measures, related clinical data were reviewed and analysed in this text. The conclusions were expected to provide important insights about the early recognition and treatment, active prevention and early intervention, and high success rate of rescue.Methods: A retrospective clinical investigation was conducted on the NPH cases in neonatal intensive care unit(NICU) of Maternal and C hild Health Hospital of Yancheng and Soochow University Affiliated Children’s Hospital, during January 2010 to December 2014. To filter suspicious risk factors, the OR value and its 95% confidence interval was calculated with use of the single- factor analysis(by using X2 test) and multipl- factors analysis(by using logistic regression statistics).Results:1. NPH incidence and clinical prognosis: During January 2010 to December 2014, in a total of 14078 cases of children patient, there were 108 NPH cases(incidence of 7.67‰) with mortality of 52.77%(57 cases).2. Single-factor analysis showed that pathogenesis of NPH was related to infectious pneumonia, neonatal asphyxia, congenital heart disease, gender, acidosis, neonatal pulmonary hyaline membrane disease, neonatal shock, PS replacement therapy, premature rupture of membranes, gestational age, birth weight and so on.3. The results of binary multivariate logistic regression analysis showed that there were five prognostic indicators of the pathogenesis of NPH. When all independent variables were entered into the logistic regression equation model, neonatal asphyxia(OR 6.854), gestational age(OR 4.826), infectious pneumonia(O R 2.475), gender(O R 2.390) and neonatal respiratory distress syndrome(OR 2.334) were significantly associated with the NPH. The results revealed that the NPH could be caused by combined action of many factors, in which these five factors play a major role.4. The key treatments of pulmonary hemorrhage included early diagnosis, positive airway pressure in time by application of breathing machine, the use of hemostatic drugs and other comprehensive treatments. The results also showed that the rescue success rate of high- frequency ventilation was significantly higher than which of conventional ventilation.Conclusions:1. NPH remains one of the most dangerous diseases in neonates with high mortality and morbidity recently.2. The main risk factors of NPH included such factors as neonatal asphyxia, gestational age, infectious pneumonia, sex and N RDS.3. The probability of NPH can be given by Regression model.