超低出生体重儿4至11岁时的随访结局  

A follow-up study of extremely low birth weight infants at four to eleven years of age

作　　者：张玉[1] 丁国芳[1] 郭立琳[1] 朱燕林[2] 孟淑珍[3] 赵阳[3] 王颖[4] 侯绍荣[4] 朴梅花[5] 张巍[6] 刘红[7] 

机构地区：[1]中国医学科学院北京协和医院儿科,100730 [2]中国医学科学院北京协和医院心内科 [3]中国医学科学院北京协和医院呼吸内科 [4]北京大学第一医院儿科,100034 [5]北京大学第三医院儿科,100191 [6]首都医科大学附属北京妇产医院新生儿科,100026 [7]首都医科大学附属北京儿童医院NICU,100045

出　　处：《中华围产医学杂志》2016年第9期715-721,共7页Chinese Journal of Perinatal Medicine

摘　　要：目的通过对超低出生体重儿（ extremely low birth weight infant, ELBWl ） 4-11岁时进行随访，分析远期严重并发症发生情况及其与生后住院期间病情的关系，了解本地区危重早产儿救治和随访的情况及存在的问题。方法研究对象为北京地区5家医院2000年1月至2009年12月救治成活的全部ELBWI。2011年5月至2013年8月，对这些ELBWI进行随访。随访内容包括收集研究对象出生时和住院期间的临床资料，并在北京协和医院对随访患儿测量体格发育情况，评估智力和运动发育情况，测定心肺功能。分析各系统疾病的发生和治疗情况，特别是严重并发症的发生情况。对数据资料进行描述性统计分析。结果（1）共随访到48例ELBWI。48例的出生胎龄为24．4-34．0周，平均（29．1±2．4）周；出生体重700-990g，平均（895±68）g；36例（75．0％）因母亲妊娠期高血压早产。39例（81．2％）为小于胎龄儿。随访时年龄4．0-10．6岁，平均年龄为（5．6±1．8）岁。36例（75．0％）来医院进行了体格检查，另12例（25．0％）仅进行电话随访。（2）48例中，31例（64．6％）的体重和28例（58．3％）的身高分别小于同龄儿童平均值。48例中的14例（29．2％）体格发育落后，其中7例仅体重、1例仅身高〈第10百分位，6例身高和体重均〈第10百分位。（3）48例中，42例（87．5％）发生新生儿呼吸窘迫综合征，11例（22．9％）支气管肺发育不良，3例（6．3％）诊断为支气管哮喘。随访时，共28例完成通气功能检查，其中4例（14．3％）为肺功能中度损害，6例（21．4％）为肺功能轻度损害，其余18例（64．3％）患儿肺功能大致正常。（4）48例中，10例（20．8％）住院期间出现动脉导管未闭，发生房室传导阻滞和发生室性早搏、室上性心动过速各1例（各2．1％）。来院随访时，2例（5．6％，2136）发现冠状Objective To analyze the relationship between the incidence of complications and disease condition during hospitalization in severe preterm infants after birth, and to understand the situation and problems in treatment of these infants through a follow up study of extremely low birth infants （ELBWls） at four to eleven years of age. Methods A follow up study was carried out in all ELBWIs who were born between January 2000 and December 2009 in five hospitals of Beijing area. The study was conducted from May 20ll to August 2013. Clinical data of these ELBWIs were collected. Development of those ELBWls was measured in the Peking Union Medical College Hospital, including physical, mental and motional development. Their cardiopulmonary functions were also examined. The incidence and treatment of disease in each system was analyzed, especially the incidence of severe complications. Descriptive statistical analysis was performed. Results （l） A total of 48 ELBWIs were followed up, with 24.4 to 34.0 weeks of gestation at birth, averaging （29.1 ± 2.4） weeks. The birth weight of those ELBWIs was 700-900 g, with an average of （895 ± 68） g. Among the 48 ELBWls, 36 （75.0%） preterm infants were delivered for maternal gestational hypertensive disorders. Thirty- nine cases （81.2%） were small for gestational age. Those ELBWIs at 4.0-10.6 years of age were followed up, with an average age of（5.6± 1.8） years. Thirty six cases （75.0%） were followed up at clinic visits, and the other 12 cases （25.0%） were followed up through telephone calls. （2） Among the 48 cases, 31（64.6%） had lower weight, and 28（58.3%） had lower height than the average level. Fourteen children （29.2%） had physical retardation, among whom, seven cases had lower height, one case had lower weight, and six cases had both lower weight and height by 10 percentile. （3） Among the 48 cases, 42 cases （87.5%） had neonatal respiratory distress syndrome, 11（22.9%） had bronchopulmonary dysplasia, and 3（6.3%）

关 键 词：婴儿 超低出生体重 随访研究 

分 类 号：R179[医药卫生—妇幼卫生保健]