先天性食管闭锁围产期死亡的危险因素分析  

Analysis of Factors of Perinatal Death in Congenital Esophageal Atresia

作　　者：朱军[1,2] 周光萱[1,2] 孙荣国 邓鸿云[3] 

机构地区：[1]成都,610041 [2]华西医科大学中国出生缺陷监测中心 [3]湖北省妇幼保健院

出　　处：《中华小儿外科杂志》1997年第6期325-327,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的:探讨影响先天性食管闭锁患儿围产期死亡的危险因素,为提高患儿的存活率提供科学的依据。方法:1986年9月～1993年12月对孕28周至出生后7天的围产儿进行监测,并就收集的195例先天性食管闭锁病例进行死亡危险因素分析。结果:先天性食管闭锁的围产期病死率为66.7%,其中新生儿7天内死亡所占比例(78.5%)显著高于死胎、死产所占比例(21.5%,P<0.001)。死亡患儿的出生体重构成比不同于活产患儿(P<0.01),低体重儿比例增加。35.9%的病例为多发畸形,病死率(85.7%)显著高于单发畸形患儿(56.0%,P<0.01)。死亡患儿伴发的严重畸形以消化(23%)、肌肉骨骼(21%)、心血管(15%)及呼吸(13%)等系统多见,而活产患儿中伴发心血管畸形的比例有明显增加(27%)。结论:患儿出生体重和伴发畸形是影响患儿围产期死亡的危险因素。Objective:To study the factors influencing perinatal death,to increase the sur- vivals and to predict the prognosis of congenital esophageal atresia(EA).Methods:The records of 195 cases with EA including stillbirth and early neonatal death,collected from 30 provinces,mu- nicipals and autonomous regions between September 1986 and December 1993 were studied.Re- sults:The perinatal mortality of EA was 66.7%,among which the proportion of early neonatal death(<7 days)was significantly higher than that of the fetal death(78.5% vs 21.5%,P< 0.001).35.9% of them had multiple malformations making the mortality significantly higher than cases of simple EA(85.7% vs 56.0%,P<0.001).Among the dead cases,there was a higher proportion of associated anomalies including the major defects in digestive system(23%),muscu- loskeletal(21%),cardiac(15%)and urogenital(13%)etc.Conclusions:The birthweight of the stillbirth is significantly different from that of livebirth(P<0.01).Low birthweight and associat- ed anomalies may be the main factors of perinatal death in the cases of EA.

关 键 词：先天性 食管闭锁 围产期 死亡 危险因素 

分 类 号：R726.554[医药卫生—儿科]