晚期早产儿中小于胎龄儿的临床特点及生长情况研究  

Clinical Features and Growth Pattern of Small for Gestational Age Infants in Late Preterm Birth

作　　者：辛玥[1] 郑荣秀[1] 刘丹[1] 

机构地区：[1]天津医科大学总医院儿科,天津市300052

出　　处：《中国全科医学》2016年第19期2288-2293,共6页Chinese General Practice

摘　　要：目的探讨晚期早产儿(LPIs)中小于胎龄儿(SGA)的临床特点及生长情况。方法选取2013年10月—2015年10月在天津医科大学总医院产科出生,且入住新生儿重症监护病房的LPIs 283例。根据患儿出生体质量与胎龄的关系,将其分为适于胎龄儿(AGA)组(n=202)和SGA组(n=81)。通过查阅病历的方法收集两组患儿的临床资料,包括一般情况、围生期情况、实验室检测指标、住院期间患病情况,以及住院时间≥14 d患儿的生长情况。结果两组患儿性别、出生胎龄、呼吸机支持比较,差异无统计学意义(P>0.05);SGA组患儿出生体质量、出生头围、自然生产低于AGA组,住院时间长于AGA组,差异有统计学意义(P<0.05)。SGA组患儿围生期产妇合并妊娠期高血压(HDCP)和妊娠期血小板减少症、羊水过少、胎儿宫内窘迫高于AGA组,差异有统计学意义(P<0.05);两组产妇合并妊娠期糖尿病(GDM)、胎盘因素、脐绕颈、多胎妊娠、初产妇、高龄产妇比较,差异无统计学意义(P>0.05)。两组患儿入院时清蛋白、AST比较,差异无统计学意义(P>0.05);SGA组患儿血糖、剩余碱(BE)、p H低于AGA组,乳酸、ALT、γ-谷氨酰转肽酶、心肌型肌酸激酶同工酶高于AGA组,差异有统计学意义(P<0.05)。SGA组患儿住院期间新生儿窒息、低血糖症、贫血、湿肺、喂养不耐受、血小板减少症高于AGA组,差异有统计学意义(P<0.05);两组患儿低钙血症、低钾血症、低蛋白血症、呼吸窘迫综合征、败血症、肺炎、高胆红素血症、消化道出血、坏死性小肠结肠炎比较,差异无统计学意义(P>0.05)。两组住院时间≥14 d患儿的生理性体质量下降程度、恢复出生体质量日龄、恢复出生体质量后平均每日体质量增长速率比较,差异无统计学意义(P>0.05);SGA组患儿出生年龄别体质量Z评分、出院年龄别体质量Z评分低于AGA组,差异有统计学意义(P<0.05)。相关分析结果显示,出院年龄别Objective To investigate the clinical features and growth pattern of small for gestational age （SGA） neonates among late preterm infants （LPIs） . Methods We enrolled 283 LPIs who were horn in the Department of Obstetrics of Tianjin Medical University General Hospital and were admitted into the intensive care unit for neonates. According to the relation between birth weight and gestational age of infants, the infants were divided into appropriate for gestational age （AGA） group （n =202） and SGA group （n = 81 ） . The clinical data of infants of the two groups were collected by reviewing medical records, including general data, perinatal condition, laboratory parameters, condition during hospitalization and growth status of these neonates with hospitalization time≥14 d. Results The two groups were not significantly different in gender, gestational age and usage of breathing machines （P 〉 0. 05 ） ; SGA group had lower birth weight, birth head circumference and number of natural birth and had longer hospital stay than AGA group （ P 〈 0. 05 ） . SGA group was higher than AGA group in the incidence rates of hypertensive disorder complicating pregnancy （ HDCP）, pregnancy - associated thrombocytopenia, oligoamnios and fetal distress in uterus of mothers （ P 〈 0. 05 ） ; the two groups were not significantly different in the incidence rates of gestational diabetes mellitus （GDM） , placental factors, umbilical cord around neck, multiple pregnancy, primipara and pregnancy at higher age （P 〉 0. 05） . The two groups were not significantly different in the levels of albumin and AST of neonates at admission （ P 〉 0.05）; SGA group was lower in blood glucose, BE and pH value and higher in the levels of lactic acid, ALT, ~/ - glutamyltranspeptidase, creatine kinase isoenzyme - MB in infants than AGA group （ P 〈 0. 05 ） . SGA group was higher than AGA group in the incidence rates of asphyxia, hypoglycemia, anemia, wet lung, feeding intolerance and thrombopenia of neonat

关 键 词：婴儿 早产 婴儿 小于胎龄 临床特点 生长情况 

分 类 号：R722[医药卫生—儿科]