住院超过30d早产儿临床特点及病因分析  

Clinical features and etiology of premature infants in hospital more than 30 days

作　　者：徐艳[1] 孟令建[1] 刘文强[1] 张文辉[1] 

机构地区：[1]徐州医学院附属医院儿科医院新生儿科,江苏徐州221002

出　　处：《中国校医》2016年第9期697-699,共3页Chinese Journal of School Doctor

基　　金：徐州市科技计划项目(社会发展)(XXZD1222)

摘　　要：目的总结本院NICU住院超过30 d早产儿的临床特点,分析导致住院时间长的原因。方法选择2011年1月—2014年12月本院NICU住院超过30 d的104例早产儿为研究对象,采用回顾性分析方法,对性别、胎龄、出生体质量、孕母导致早产的高危因素、Apgar评分、住院期间合并症、转归、住院费用等进行总结和分析。结果在这104例早产儿中,男62例,女42例,平均胎龄(31.0±2.1)周,平均出生体质量(1 506±341)g,其母妊高症、重度子痫前期、胎膜早破是导致早产主要原因(64例,67.8%),5 min Apgar评分<7分的占71.7%,合并症中常见的以新生儿呼吸窘迫综合征(NRDS)最多见,共89例(85.6%),84例(80.8%)患儿有呼吸机使用史,其中有创机械通气60例(57.7%),平均呼吸机使用时间(14.3±9.9)d,使用肺表面活性剂的87例(83.7%),其次是新生儿肺炎和呼吸机相关性肺炎(61.5%)、呼吸暂停(48.1%)、新生儿败血症(40.4%)、慢性肺病(32.7%)。好转出院90例(86.5%),放弃11例,死亡3例,出院时宫外发育迟缓80例(76.9%),有33例出院前行头颅MRI或CT、脑干诱发电位检查,均有不同程度异常。平均住院时间(40.7±10.8)d,人均住院费用(50 299±18 314.2)元。结论胎龄、出生体质量、合并症多且重是导致早产儿住院时间长的主要原因,而合并症中仍以呼吸系统疾病和感染为主,积极预防早产和治疗各种早产儿并发症是缩短早产儿住院时间的重要举措。Objective To summary the clinical features of premature infants at neonatal intensive care unit（NIUC）in the hospital for more than 30 days and analyzethe causes of a long time in the hospital. Methods A retrospective analysis was conducted at NICU in the affiliated hospital of Xuzhou Medical College. A total of 104 premature infants at NICU for more than 30 days were recruited from January 2011 to December 2014. Sex,gestational age,birthweight,maternal high risk factors leading to preterm, Apgar scores, complications, outcomes, and hospitalization expense were summarized.Results Among the 104 premature infants,there were 62 male and 42 female. The average gestational age was（31.0±2.1）weeks, and the average birth weight was（1506±341） g. Hypertension of pregnancy,preeclampsia, and premature rupture of membranes were mainly responsible for premature birth. The rate of 5 min Apgar score less than 7 points was 71.7%.Neonatal respiratory distress syndrome（NRDS）（n=89,85.6%）was the most common complication. Totally 84 infants（80.8%）used ventilators, and among them, 60（57.7%） used mechanical ventilation. The average respirator use time was（14.3 ±9.9）days. A total of 87 infants（83.7%） used pulmonary surfactant. Other complications included neonatal pneumonia and ventilator associated pneumonia（61.5%）, apnea（48.1%）, neonatal sepsis（40.4%）, and chronic lung disease（32.7%）. Ninety infants（86.5%）improved, 11 gave up the treatment, and 3 died. The incidence of extrauterine growth restriction（n=80,76.9%）was significantly high at discharge.Only 33 patients did head MRI or CT before hospital discharge, and they all had different levels of abnormal results. The average hospital staytime was（40.7±10.8） days, and the average per capita hospitalization cost was（50 299±18 314.2） Yuan. Conclusion Gestational age, birth weight, and a variety of severity complications are mainly responsible for premature infants who have the prolonged hospitalized time. Respiratory s

关 键 词：婴儿 早产/流行病学 住院时间 婴儿 早产/治疗 

分 类 号：R722[医药卫生—儿科]