The Clinical Analysis And The Intervention Strategies Study On 60 Newborns With Neonatal Pulmonary Hemorrhage

ObjectiveTo study the related factors, clinical manifestations and process of diagnosis and treatment of 60 newborns with pulmonary hemorrhage. To investigate the related risk factors of neonatal pulmonary hemorrhage, to analyze the clinical manifestations and to study the effect by different diagnosis and treatment measures so as to make prevention and treatment measures according to local character, decrease the incidence of neonatal pulmonary hemorrhage and improve the prognosis of patients of neonatal pulmonary hemorrhageMethods60 newborns who were diagnosed neonatal pulmonary hemorrhage and were all conformed to the diagnostic standard made by newborn group of pediatrics group of China Medical Association in 2001 in newborn intensive care of our hospital from January,2006 to November,2008 were looked on as observed group. The clinical information were analyzed retrospectively and the clinical character were summarized in order to investigate the related factors of neonatal pulmonary hemorrhage and the effect by giving all kinds of intervention measures. In order to investigate the related factors of neonatal pulmonary hemorrhage,60 newborns who were diagnosed neonatal pulmonary hemorrhage in newborn intensive care of our hospital from January,2006 to November,2008 were looked on as observed group. At the same time 120 newborns without pulmonary hemorrhage in the same period in hospital were looked on as control group.Twenty possible related factors such as physiological factors(gestational age, weight, sex and delivery methods),pathological factors (hypertensive disorder complicating pregnancy, diabetes mellitus complicating pregnancy,premature rupture of membrane, neonatal asphyxia or neonatal hypoxic-ischemic encephalopathy, neonatal intracranial hemorrhage, infectious pneumonia, aspiration of meconium,neonatal wet lung, low temperature and cold injure, congenital heart disease, hyperbilirubinemia, neonatal hyaline membrane disease and disseminated intravascular coagulation) and iatrogenic factors (exogemous pulmonary surfactants replacement, oxygen intoxication and incorrect mechanical ventilation) between two groups were given single factor analysis and multi factors analysis. Statistics method adopted SPSS 13.0 statistics software. Single factor analysis applied x2 test and P<0.05 had statistical significance. Multi factors analysis applied Logistic regression analysis. OR value and 95% confidence intervals of OR were counted in order to get the relations of all kinds of related factors on the risk of pathogenicity. At the same time, the early clinical manifestations were summarized so as to find the occurrence of pulmonary hemorrhage earlier. The effect by different treatment methods were compared. Treatment methods included inspiring oxygen, anti-infection, improving respiratory and circulation and etc in control group, while mechanical ventilation were applied on the base of the complexed measures in the treatmengt group.The treatment included application of mechanical ventilation, time of orotacheal intubition and tracheal instillation of hemostatic drugs in application of mechanical ventilation group. Comparison of curation rate applied x2 test.ResultsThe incidence rate of neonatal pulmonary hemorrhage was high in recent two years in our hospital. It showed that hypertensive disorder complicating pregnancy, premature, low weight, neonatal asphyxia or neonatal hypoxic-ischemic encephalopathy, neonatal intracranial hemorrhage, infectious pneumonia, low temperature and cold injure and application of mechanical ventilation had obvious difference(P<0.05) and diabetes mellitus complicating pregnancy,premature rupture of membrane, sex,delivery methods, aspiration of meconium, neonatal wet lung,congenital heart disease, hyperbilirubinemia, neonatal hyaline membrane disease, disseminated intravascular coagulation, exogemous pulmonary surfactants replacement and oxygen intoxication had not obvious difference(P>0.05) by single factor analysis. It showed that hypertensive disorder complicating pregnancy, premature, low weight, neonatal asphyxia or neonatal hypoxic-ischemic encephalopathy, neonatal intracranial hemorrhage, infectious pneumonia, low temperature and cold injure and application of mechanical ventilation were the main risk factors by multi factors Logistic regression analysis. The living rate of neonatal pulmonary hemorrhage was obviously increased by using mechanical ventilation. Orotacheal intubition earlier and tracheal instillation of hemostatic drugs could decreased the death rate of neonatal pulmonary hemorrhage.ConclusionHypertensive disorder complicating pregnancy, premature, low weight, neonatal asphyxia or neonatal hypoxic-ischemic encephalopathy, neonatal intracranial hemorrhage, infectious pneumonia, low temperature and cold injure and incorrect application of mechanical ventilation are the related factors of neonatal pulmonary hemorrhage. It showed that hypertensive disorder complicating pregnancy, premature, low weight, neonatal asphyxia or neonatal hypoxic-ischemic encephalopathy, neonatal intracranial hemorrhage, infectious pneumonia, low temperature and cold injure and application of mechanical ventilation were the main risk factors by multi factors Logistic regression analysis.To find and treat the related risk factors of neonatal pulmonary hemorrhage earlier has important significance of preventing pulmonary hemorrhage. The early clinical manifestations of neonatal pulmonary hemorrhage have not specificity. Neonatal pulmonary hemorrhage treated by correct application of mechanical ventilation has good effect.Orotacheal intubition earlier and tracheal instillation of hemostatic drugs should be given. Given effective prevention and treatment measures can increase the living rate of neonatal pulmonary hemorrhage.