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目的探讨高危新生儿多脏器功能损害(Multiple organ dysfunction,MODS)发生率与出生时状况的相关性,以早期诊断并及时给予干预和治疗,改善预后。方法将NICU2009年1月—2010年1月收治危重新生儿脏器损害数目≥2个的诊断为新生儿MODS;按出生时不同状况:胎龄、出生体重、有无宫内窘迫或窒息MODS发生率,各组间MODS发生率的比较采用计数资料χ2检验,P<0.05为有统计学意义;MODS发生率与胎龄及出生体重的相关性用统计学直线相关分析法,P<0.05为有统计学意义。结果新生儿MODS 199例,早产儿175例,占本组MODS的87.9%,明显高于足月儿,早产儿与足月儿MODS发生率比较差异显著,有统计学意义(χ2=17.866,P<0.05);在不同胎龄MODS发生率的比较中,低出生体重儿169例占本组84.9%,低出生体重儿及正常出生体重儿MODS发生率比较差异显著(χ2=19.215,P<0.05);出生体重及胎龄与发病率相关性分析结果呈负相关(r=-0.9356,r=-0.7918,P<0.05);有窒息史(包括宫内窘迫)新生儿MODS发生率为70.6%,与无窒息组发生率比较差异显著,有统计学意义(χ2=1.502E2,P<0.05)。结论早产、低出生体重、窒息是导致新生儿MODS主要原因;新生儿MODS发生率与胎龄及出生体重呈负相关。
Objective To explore the correlation between the incidence of multiple organ dysfunction (MODS) and the status at birth in high-risk neonates. To early diagnosis and timely intervention and treatment to improve the prognosis. Methods NICU from January 2009 to January 2010 admitted to critically ill neonates with organ damage ≥ 2 diagnosed as neonatal MODS; according to different conditions at birth: gestational age, birth weight, with or without intrauterine distress or asphyxia MODS Rate, the incidence of MODS among the groups using the count data χ2 test, P <0.05 was considered statistically significant; MODS incidence and gestational age and birth weight correlation statistical linear correlation analysis, P <0.05 as Statistical significance. Results There were 199 newborns with MODS and 175 premature infants, accounting for 87.9% of MODS in this group, which was significantly higher than that of full-term infants. The incidence of MODS in preterm and full-term infants was significantly different (χ2 = 17.866, P <0.05). In the comparison of MODS incidences at different gestational ages, 169 cases of low birth weight children accounted for 84.9% of the group, the incidence of MODS was significantly different between low birth weight children and normal birth weight children (χ2 = 19.215, P <0.05 ); Birth weight and gestational age were negatively correlated with incidence of morbidity (r = -0.9356, r = -0.7918, P <0.05). The incidence of MODS in neonates with history of asphyxia (including intrauterine distress) was 70.6% , There was significant difference with the incidence of asphyxia group (χ2 = 1.502E2, P <0.05). Conclusions Preterm birth, low birth weight and asphyxia are the main causes of neonatal MODS. The incidence of neonatal MODS is negatively correlated with gestational age and birth weight.