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目的分析影响新生儿休克死亡的相关因素。方法回顾性分析中国医科大学附属盛京医院新生儿病房2007年1月至2009年4月收治的50例休克新生儿临床资料。比较存活与死亡患儿的临床特点并进行单因素χ2检验和多因素Logistic回归分析。结果存活26例,死亡24例,病死率48.0%。50例中,足月儿36例,死亡14例,病死率38.9%;早产儿14例,死亡10例,病死率71.4%。休克类型以感染性休克为主,共29例(占58.0%),其中早产儿感染性休克9例,占早产儿休克64.3%;败血症为其主要基础疾病。休克合并器官功能衰竭42例,其中合并肺功能衰竭31例,占首位(73.8%)。χ2检验单因素分析结果显示,胎龄、入院体重、日龄、5分钟Apgar评分、pH值、血压、器官功能衰竭对新生儿休克死亡有显著影响(P均<0.05);多因素Logistic回归分析共筛选出3个影响因素,分别是胎龄(OR=0.006,95%CI0.000-0.583,P=0.028)、血压(OR=0.025,95%CI0.002-0.297,P=0.004)、多器官功能衰竭(OR=14.949,95%CI1.181-189.250,P=0.037)。结论新生儿休克所致的死亡与胎龄、血压、多器官功能衰竭显著相关。
Objective To analyze the related factors that affect the neonatal shock death. Methods The clinical data of 50 newborn infants admitted to the neonatal ward of Shengjing Hospital of China Medical University from January 2007 to April 2009 were retrospectively analyzed. The clinical features of children surviving and death were compared and analyzed by single factor χ2 test and multivariate logistic regression analysis. Results Survival in 26 cases, 24 deaths, the mortality rate was 48.0%. In 50 cases, 36 full-term infants died of fourteen cases with a mortality rate of 38.9%, 14 were premature infants and 10 died, with a mortality rate of 71.4%. Septic shock type, a total of 29 cases (58.0%), of which 9 cases of septic shock in preterm children, accounting for 64.3% of premature children with shock; sepsis as its main underlying disease. Forty-two cases were complicated with organ failure in shock, of which 31 cases were complicated with pulmonary failure, accounting for the first place (73.8%). Chi-square test univariate analysis showed that gestational age, admission weight, age, 5-minute Apgar score, pH, blood pressure, organ failure had a significant impact on neonatal shock death (all P <0.05); multivariate Logistic regression analysis A total of three influential factors were selected, which were gestational age (OR = 0.006,95% CI0.000-0.583, P = 0.028), blood pressure (OR = 0.025,95% CI0.002-0.297, P = 0.004) Organ failure (OR = 14.949, 95% CI 1.81-189.250, P = 0.037). Conclusions Neonatal shock-related deaths are significantly associated with gestational age, blood pressure, and multiple organ failure.