The Research About Neonatal Pulmonary Hemorrhage And The Result

ObjectiveTo investigate the related risk factors、the results and the correlation between changes in parameters of platelet with neonatal pulmonary hemorrhage, so as to provide guidance for early identification and treatment.MethodsA hospital based on1:2matched case control study was carried. A total of69cases neonatal pulmonary hemorrhage and138newborns without pulmonary hemorrhage in the same period in our hospital were from the newborn intensive carefrom, the Zhang Zhou Affiliated Hospital of Fujian Medical University from January2005to December2011.ResultsTotal9334cases neonates hospitalized during the seven years.74cases were diagnosed neonatal pulmonary hemorrhage, the rate was7.92%o. The first section:On the basis of condition about the group-control,69cases could be to pair. After the single factor analysis and the multi factors analysis controlled the confounding bias, We screened five related risk factors, including low temperature(OR=3.350,95%CI;1.195～15.455); intracranial-hemorrhage(OR=15.340,95%CI:1.645～20.321); heart-failure(OR=225.300,95%CI:22.250～809.730); low blood sugar (OR=5.950,95%CI:1.195～15.455); neonatal convulsions(OR=34.600,95%CI:5.251～180.940).The second section:The different results of neonatal pulmonary hemorrhage were connected with aspiration pneumonia、coagulation abnormalities、DIC heartfailure、using bicarbonate and MPV. After the multi factors analysis controlled the confounding bias,We screened three related risk factors:DIC(OR=6.897,95%CI;1.514～31.419). heartfailure(OR=9.622,95%CI:1.710～54.150)、MPV before pulmonary hemorrhage (OR=7.009,95%CI:1.475～33.312), a protective factor was using bicarbonate before pulmonary hemorrhage(OR=0.250,95%CI:0.062 1.009).The third section:PLT, MPV, PCT and PDW of infants with NPH were188.2±84.6X109L,9.84±0.92,0.21±0.07,12.9±3.20, respectively. PLT, MPV, PCT and PDW of infants without NPH were240.2±95.3X109/L,9.99±1.13,0.22±0.06,11.4±1.46, respectively. PLT of the case-group was lower, but PDW was greatly higher. There were significant differences about PLT and PDW between the two groups(P<0.001). The cases about thrombocytopenia(PLT<150X109/L)between the case-contrast groups were respectively19(27.54%) and20(14.49%). but platelet-large between the two groups were respectively55(79.71%) and125(90.58%). The cases about PDW(≥14%) were respectively7(5.07%)and26(37.68%). Contrasting the two groups, the difference was significant.(X2=5.118,4.792,2.278, respectively, P<0.05). Among the69cases with NPH,40cases were dead, there were4cases with platelet-large (4/40,10.00%).The29cases were survival, there were11cases with platelet-large (11/29,37.90%).The platelet-large on the survival group was greatly higher than the dead group(X2=14.73, P<0.001).ConclusionIt showed that low temperature, intracranial hemorrhage, heart failure, low blood sugar and neonatal convulsions were the main risk factors. The neonatal pulmonary hemorrhage with DIC,low MPV and heartfailure was more likely to die,.But using bicarbonate before pulmonary hemorrhage could play a part in increase the survival rate of pulmonary hemorrhage.The difference of the parameters of platelet possibly took park in the pathogenesis of neonatal pulmonary hemorrhage,We should pay attention to monitor parameters of platelet, so as we could be on guard against neonatal pulmonary hemorrhage as early as possible.What’s more, we could reduce fatality rate by early intervenor.