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[目的]探讨新生儿胎粪吸入综合征(MAS)并发持续肺动脉高压(PPHN)的危险因素。[方法]对2007年1月至2009年10月福建省妇幼保健院新生儿科重症监护病房收治的127例MAS临床资料进行分析,其中45例并发PPHN(35.4%),82例无并发PPHN(64.6%)。分别比较2组患儿分娩方式、胎龄、出生体重、有无胎膜早破、出生Apgar评分、入院第1次血气分析、入院时有无其他合并症(气胸、肺炎、心力衰竭)。[结果]MAS患儿PPHN的发生主要与出生重度窒息、酸中毒、合并气胸有关,与分娩方式、胎龄、出生体重、有无胎膜早破、出生轻度窒息、合并肺炎和心力衰竭关系不大。[结论]出生重度窒息、酸中毒、合并气胸是MAS并发PPHN的危险因素。预防宫内缺氧及产时窒息、尽快纠正酸中毒、避免气胸发生是降低MAS患儿PPHN的发生率和病死率的关键。
[Objective] To explore the risk factors of neonatal meconium aspiration syndrome (MAS) complicated with persistent pulmonary hypertension (PPHN). [Methods] The clinical data of 127 cases of MAS treated in Neonatology Intensive Care Unit of Fujian Maternal and Child Health Hospital from January 2007 to October 2009 were analyzed. Among them, 45 cases were complicated with PPHN (35.4%), 82 cases without concurrent PPHN %). The mode of delivery, gestational age, birth weight, premature rupture of membranes, Apgar score at admission, the first blood gas analysis at hospital admission and other complications (pneumothorax, pneumonia, heart failure) at admission were compared between the two groups. [Results] The incidence of PPHN in children with MAS was mainly associated with severe birth asphyxia, acidosis and pneumothorax and the mode of delivery, gestational age, birth weight, premature rupture of membranes, mild suffocation at birth, pneumonia complicated with heart failure Not big. [Conclusion] Severe neonatal asphyxia, acidosis and pneumothorax are the risk factors for MAS complicated with PPHN. Prevention of intrauterine hypoxia and asphyxia during labor, as soon as possible to correct acidosis and avoid pneumothorax is the key to reduce the incidence of PPHN and mortality in children with MAS.