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目的探讨新生儿胎粪吸入综合征(MAS)引起肺动脉高压(PPHN)的临床特点。方法 132例MAS新生儿,将其中24例引起PPHN新生儿作为观察组,108例未引起PPHN新生儿作为对照组。所有新生儿入院均行常规检查,观察两组新生儿治疗情况并对引起PPHN因素进行分析。结果 132例新生儿中,38例(28.79%)存在青紫色。两组新生儿MAS引起PPHN危险因素包括:新生儿重度窒息(OR=2.588,95%CI=1.132,6.155)、酸中毒(OR=9.665,95%CI=4.521,23.148)、合并气胸(OR=18.163,95%CI=3.895,77.165)是致使新生儿MAS引起PPHN的主要因素。观察组22例(91.67%)痊愈,1例(4.17%)死亡,1例(4.17%)病情危重家属放弃治疗;对照组106例(98.15%)痊愈,2例(1.85%)病情危重放弃治疗。结论新生儿重度窒息、酸中毒、合并气胸是致使新生儿MAS引起PPHN的主要因素,及时预防宫内缺氧、纠正酸中毒及避免气胸可显著降低新生儿MAS引起PPHN的发生率。
Objective To investigate the clinical features of pulmonary hypertension (PPHN) caused by neonatal meconium aspiration syndrome (MAS). Methods A total of 132 newborns with MAS were enrolled in this study. Twenty-four newborns with PPHN were selected as observation group and 108 newborn infants without PPHN as control group. All newborns were admitted to hospital routine examination, observation of neonatal treatment of two groups and analysis of factors that cause PPHN. Results Of 132 newborns, 38 (28.79%) had cyanosis. The neonatal MAS-induced PPHN risk factors included severe neonatal asphyxia (OR = 2.588,95% CI = 1.132,6.155), acidosis (OR = 9.665,95% CI 4.521,23.148), pneumothorax (OR = 18.163, 95% CI = 3.895, 77.165) is a major factor that causes neonatal MAS-induced PPHN. In the observation group, 22 cases (91.67%) recovered, 1 (4.17%) died and 1 (4.17%) critically ill relatives gave up their treatment. 106 cases (98.15%) recovered and 2 . Conclusions Neonatal severe asphyxia, acidosis and pneumothorax are the main factors leading to neonatal MAS-induced PPHN. Preventing intrauterine hypoxia, correcting acidosis and avoiding pneumothorax can significantly reduce the incidence of PPHN caused by neonatal MAS.