极低和超低出生体重儿临床分析  

Clinical analysis of characteristics of very low birth weight infants and extremely low birth weight infants

作　　者：李爱月[1] 杨宇萍[1] 

机构地区：[1]内蒙古鄂尔多斯市中心医院新生儿科,017000

出　　处：《中国新生儿科杂志》2016年第1期24-27,共4页Chinese Journal of Neonatology

摘　　要：目的探讨极低出生体重（VLBW）和超低出生体重（ELBW）婴儿母亲孕期危险因素、生后并发症、治疗及转归。方法采用回顾性分析法对2013年7月至2015年7月我院收治的VLBW/ELBW婴儿临床资料进行分析。结果共纳入VLBW/ELBW婴儿148例,其中胎龄〈28周20例,28~31周89例,32~36周39例（包括小于胎龄儿28例）;出生体重〈1 000 g 16例,1 000~1 249 g 54例,1 250~1 499 g 78例。VLBW/ELBW婴儿母亲孕期危险因素前五位分别为：妊娠期高血压综合征58例（39.2%）,双胎或多胎36例（24.3%）,高龄孕妇（≥35岁）32例（21.6%）,胎膜早破30例（20.3%）,试管婴儿16例（10.8%）;VLBW/ELBW婴儿最常见并发症为新生儿窒息（76例,51.4%）和新生儿呼吸窘迫综合征（RDS）（66例,44.6%）。体重〈1 000 g组、胎龄〈28周组RDS发生率明显高于其他组;胎龄28~31周组、体重1 000~1 249 g组新生儿肺炎发生率明显高于其他组;胎龄〈28周组、体重1 000~1 249 g组呼吸暂停发生率明显高于其他组;体重1 000~1 249 g组贫血发生率明显高于其他组。148例患儿存活106例,死亡42例,病死率28.4%。ELBW婴儿存活率25.0%,VLBW婴儿存活率77.3%。引起死亡的主要原因为家属放弃治疗,其次为肺出血、RDS和重症感染。结论加强围产期保健、提高自然受孕率、积极预防和治疗各种并发症可以提高VLBW/ELBW婴儿存活率。Objective To study the risk factors of their mothers during pregnancy, complications, treatments and outcomes of very low birth weight （VLBW） infants and extremely low birth weight （ELBW） infants. Methods VLBW and ELBW infants admitted to our hospital from July 2013 to July 2015 were recruited and their clinical data retrospectively reviewed and analyzed. Results A total of 148 infants were recruited. 20 cases with gestational age （GA） 〈 28 weeks, 89 cases with GA 28 - 31 weeks and 39 with GA 32 -36 weeks （28 infants in this group were small for gestational age）. The infants were assigned into three groups according to their birth weight （BW）. 16 cases with BW less than 1 000 g, 54 eases with BW 1 000 - 1 249 g and 78 with BW 1 250 - 1 499 g. The top five risk factors of their mothers during pregnancy were pregnancy induced hypertension syndrome （ 58 cases, 39. 2% ） , muhifetal pregnancy （36 cases, 24.3% ）, aged （older than 35 years old） pregnant woman （32 cases, 21.6% ）, premature rupture of the membranes （30 cases, 20. 4% ） and test-tube baby （16 cases, 10. 8%）. Neonatal asphyxia （76 cases, 51.4%） and neonatal respiratory distress syndrome （RDS） （66 cases, 44. 6% ） were the most common complications of VLBW and ELBW infants. The incidence of RDS was significantly higher in infants with BW 〈 1 000 g and GA 〈 28 weeks. Neonatal pneumonia was most common in infants with GA of 28 - 31 weeks and BW of 1 000 - 1 249 g. Apnea was most common in infants with GA 〈 28 weeks and BW1 000 - 1 249 g. Anemia was most common in infants with BW 1 000 - 1 249 g. The mortality of all 148 infants was 28.4%. The survival rate of ELBW infants was 25.0%, and VLBW infants 77.3%. The leading causes of death were discontinued treatments, pulmonary hemorrhage, RDS and severe infection. Conclusions Improve perinatal medical care, increase natural conception rate, prevent and treat various complications were effective methods to improve the survival rate of VLBW and ELBW infan

关 键 词：婴儿 极低出生体重 婴儿 超低出生体重 危险因素 并发症 病死率 

分 类 号：R722.6[医药卫生—儿科]