The Clinical Study On High Risk Factors Of The 57 Cases Of Persistent Pulmonary Hypertension Of The Newborn

Persistent pulmonary hypertension of the newborn(PPHN)is one of the emergency cases in neonatal intensive care unit. PPHN occurs in as many as 6.8 of 1000 live births.Mortality is 10% to 20% with high-frequency ventilation,surfactant,inhaled nitricoxide,and extracorporeal membrane oxyg- -enation,but is much higher when these therapies are not available. Therefore,if we understand general features of PPHN and recognize its high risk factors,we can prevent it effectively,discover it early and treat it promptly,reduce the mortality.The objective is to explore the correlated high risk factors,provide theory and clinical instruction to prevent PPHN.We chosed 57 neonates with PPHN between Janurary 2009 and December 2010 in our department. Among the total,31 patients'were preterm infants,including 8 patient's gestation age was less than 30 weeks,20 patients'gestation age was less 34 weeks but exceeded 30 weeks,3 patients'gestation age was less 37 weeks but exceeded 34 weeks,and the other 26 patients were term infants. We also randomly selected 120 neonatal infants without PPHN at the same period as the control group. Among the total,16 patient's gestation age was less than 30 weeks,40 patients'gestation age was less 34 weeks but exceeded 30 weeks,6 patients'gestation age was less 37 weeks but exceeded 34 weeks,and 52 patients'gestation were term infants. We analyzed 19 factors with the methods of single and multiply-factors Logistic analysis: mothers with disease of pregnancy-induced hypertension syndrome or diabetes mellitus,birth weight ,gender,mode of delivery,whether have labor symptoms,one of multiplets,premature rupture of membranes,placenta disea- -se,cord around neck,meconium amniotic fluid,fetal distress,asphyxia,wet lu ng,neonatal severe pneumonia,respiratory distress syndrome,meconium aspiration syndrome,sepsis,congenital heart disease et al. Results:Through single factors analysis,the possible high risk factors of PPHN include asphyxia,premature rupture of membranes,neonatal severe pneumonia, respiratory distress syndrome,congenital heart disease.Through multiply factors Logistic analysis,neonatal severe pneumonia,respiratory distress syndrome have significant difference,which are the independence high risk factors of PPHN.The incidence of PPHN is 0.9%,which is more than foreign. In this study,for the morbidity of PPHN,the preterm neonates are more than term neonates,compared with the neonates at the same period,(26/4144,31/2139,χ~2= 10.3),P<0.05.It have significant difference. During the 57 cases of PPHN,32 neonates died,including 21 cases of preterm neonates and 11 cases of term neonates.Mortality is 56%.The mortality between preterm and term neonates have no significant difference(21/31,11/26,χ~2=1.06,P>0.05). So,we can draw a conclusion: mortality of PPHN is high. Neonatal severe pneumonia,respiratory distress syndrome are the independence high risk factors of the PPHN. We should treat these deseases timely,prevent the occur of PPHN.