Analysis Of Clinical And High Risk Factors Of Pneumothorax In Neonates

Objective: To analyze the clinical data of neonatal pneumothorax(NP) retrospectively, and discuss the clinical risk factors and diagnosis of NP, in order to prevent and intervene NP, so that the theoretical basis is provided to decrease the incidence of NP, and increase the successful rescue rate.Methods: We collected and analyzed retrospectively 118 NP cases who were hospitalized in neonatal department of Yancheng Maternity and Child Health Care Hospital and neonatal intensive care unit of Suzhou University Affiliated Children’s Hospital from Dec, 2012 to Dec, 2015. 118 cases without NP were compared(hospitalized at the same period). We analyzed 23 factors such as maternal parity, gestational age, delivery mode, fetal intrauterine distress or not, gender, birth weight, Apgar score, condition of amniotic fluid, umbilical cord and placenta, mechanical ventilation, singletons/multiplets, acidosis or not, white blood cell count, infectious pneumonia, RDS, MAS, wet lung, malformation, congenital heart disease, gestational hypertension and diabetes mellitus. SPSS21.0 was used for single factor analysis and multivariate Logistic regression analysis, meanwhile we compared conventional and high frequency mechanical ventilation in 118 NPs.Results:1. Incidence rate and clinical prognosis of NP: Our data shows 9371 neonates were hospitalized in neonatal department of Yancheng Maternity and Child Health Care Hospital and neonatal intensive care unit of Suzhou University Affiliated Children’s Hospital from Dec, 2012 to Dec, 2015, 118 cases are NPs, morbidity rate is 1.26%, 10 cases are dead, mortality rate is 8.47%.2. Single factor analysis shows that NP are related with delivery mode, mechanical ventilation, acidosis, white blood cell count, infectious pneumonia and gestational hypertension, their P values are 0.004, 0.001, 0.002, 0.003, 0.000 and 0.004 respectively.3. Logistic regression analysis shows that 5 independent factors are related with NP, delivery mode(OR-2.683, 95%CI 1.399-5.148, P=0.004), mechanical ventilation(OR-2.791, 95%CI 1.266-6.150, P=0.001), white blood cell count(OR-1.085, 95%CI 1.030-1.143, P=0.003), infectious pneumonia(OR-9.642, 95%CI 4.786-19.426, P=0.000), gestational hypertension(OR-4.882,95%CI 1.508-15.811,P=0.004).4. To use resuscitation kit and respirator can prevent NP, the key point is early diagnosis, sedation and oxygen inhalation, thoracocentesis, thoracic close drainage and mechanical ventilation.Conclusions:1. NP is still a critical disease in neonates, which has a high incidence rate.2. Delivery mode, mechanical ventilation, acidosis, white blood cell count, infectious pneumonia and gestational hypertension are main risk factors at NP.3. Logistic regression model can predict the incidence of NP.