目的:分析胎粪污染羊水(MSAF)新生儿发生胎粪吸入综合征(MAS)的风险评估简表构建及预测效果.方法:收集 2023年 1 月至 2023 年 12 月江西信丰县妇幼保健院收治的MSAF新生儿60 例为研究对象,根据是否并发MAS分无MAS组、MAS组,回顾性收集两组患儿一般资料、实验室检查指标、母亲一般资料等进行分析.应用多因素Logistic回归分析MSAF新生儿发生MAS的危险因素,基于危险因素构建MSAF新生儿发生MAS的风险评估简表,并采用受试者特征曲线(ROC)验证该风险评估简表的预测效果.结果:本研究共纳入 60 例MSAF新生儿,发生MAS的患儿 21 例(35.00%);MAS组1 min阿普加(Apgar)评分、胎膜早破发生率、羊水过少、外周血白细胞(WBC)、降钙素原(PCT)较无MAS组明显高(P＜0.05);MAS组酸碱值(pH值)、碱剩余(BE值)较无MAS组明显低(P＜0.05).经多因素Logistic回归分析示,羊水过少、pH值、WBC及 1 min Apgar评分(4 个)是MSAF新生儿发生MAS的独立危险因素(P＜0.05).依据Logistic回归分析结果构建胎粪污染羊水新生儿发生 MAS 的风险评估简表,ROC 分析显示其预测 MAS 的曲线下面积为 0.955(95%CI:0.920～0.974),敏感性为 85.71%,特异性为 92.31%.结论:MSAF新生儿发生MAS的独立危险因素有羊水过少、pH值、WBC及1 min Apgar评分,以此构建风险评估简表模型,预测效果显著.
Construction of a risk assessment short form for meconium aspiration syndrome in neonates with meconium-stained amniotic fluid and verification of its predictive effect
Objective:To construct a risk assessment short form for meconium aspiration syndrome(MAS)in neonates with meconium-stained amniotic fluid(MSAF),and analyze its predictive effect.Methods:Sixty neonates with MSAF admitted to Xinfeng Maternal and Child Health Hospital in Jiangxi Province from January to December 2023 were selected as the research subjects.They were assigned to the non-MAS group and the MAS group.General information,laboratory indicators,and maternal general information of the two groups were analyzed retrospectively.Multivariate logistic regression analysis was conducted to identify the risk factors for MAS in neonates with MSAF,and a risk assessment short form for MAS in neonates with MSAF was constructed based on these risk factors.The predictive effect of this risk assessment short form was evaluated using the receiver operating characteristic(ROC)curve.Results:In this study,21(35.00%)neonates developed MAS.1-minute Apgar score,the incidence rates of premature rupture of membranes and oligohydramnios,peripheral blood white blood cell count(WBC),and procalcitonin(PCT)level in the MAS group were significantly higher than those in the non-MAS group(P<0.05).pH value and BE value of the MAS group were significantly lower than those of the non-MAS group(P<0.05).Multivariate logistic regression analysis showed that oligohydramnios,pH value,WBC,and 1-minute Apgar score were independent risk factors for MAS in neonates with MSAF(P<0.05).Based on above results,a risk assessment short form for MAS in neonates with MSAF was constructed.ROC curve analysis showed that the area under the curve of this form for predicting MAS was 0.955(95%CI:0.920-0.974).Its sensitivity and specificity were 85.71%and 92.31%.Conclusion:Oligohydramnios,pH value,WBC,and 1-minute Apgar score are independent risk factors for MAS in neonates with MSAF.The risk assessment short form constructed based on these factors has marked predictive effect.
万方数据
维普
