超早产儿和超低出生体重儿存活情况和住院并发症分析  

Rates of survival and complications among extremely preterm infants and extremely low birth weight infants

作　　者：张应绩 杨传忠[1] 李欢[1] 石玉萍[1] 黄智峰[1] 熊小云[1] 余霞娟[1] 朱小瑜[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院新生儿科,518028

出　　处：《中华围产医学杂志》2016年第10期755-760,共6页Chinese Journal of Perinatal Medicine

基　　金：深圳市知识创新计划基础研究项目（JCYJ20140414142131617）

摘　　要：目的 总结超早产儿和超低出生体重儿（extremely low birth weight infant，ELBWI）的存活率及并发症发生情况。方法 2009年1月1日至2015年12月31日南方医科大学附属深圳妇幼保健院新生儿重症监护病房共收治超早产儿（259例，胎龄〈28周）及超低出生体重儿（239例，出生体重〈1 000 g）335例[其中超早产ELBWI（胎龄〈28周且出生体重〈1 000 g）163例]。回顾病历资料，比较并分析2009年到2015年不同胎龄超早产儿和不同出生体重ELBWI的存活率及并发症发生情况。采用趋势χ^2检验进行统计学分析。结果 超早产儿中位胎龄为27周（22＋6-27周＋6）；ELBWI的出生体重中位数为880 g（450-998g）。2009年超早产儿和ELBWI的存活率为42.9%（9/21），至2015年达到85.3%（58/68），呈逐年上升趋势（χ^2趋势=21.643，P=0.001）。259例超早产儿的治愈率和存活率分别为64.1%（166/259）和71.0%（184/259）；239例ELBWI的治愈率和存活率分别为64.4%（154/239）和70.7%（169/239）；超早产ELBWI的治愈率和存活率分别为62.6%（102/163）和69.9%（114/163）。超早产儿胎龄〈24周时存活率为1/7，随胎龄增加存活率呈上升趋势，至胎龄≥27-〈28周时达到81.4%（118/145）（χ^2趋势=36.037，P=0.000）。ELBWI出生体重〈500 g时存活率为0/2，随出生体重增加存活率呈上升趋势，至出生体重≥900-〈1 000 g时达到80.7%（88/109）（χ^2趋势=26.505，P=0.000）。335例患儿并发症发生率依次为新生儿呼吸窘迫综合征85.1%（285/335）、脑室内出血48.1%（161/335）、支气管肺发育不良45.1%（151/335）、动脉导管未闭40.9%（137/335）、早产儿视网膜病30.1%（101/335）、脑室周围白质软化4.2%（14/335）、医院内获得性感染3.0%（10/335）以及≥Ⅱa期新生儿坏死性小肠结肠炎2.1%（7/335）。超早产儿随出生胎龄增加，新生儿呼吸窘迫综合征、动脉导管未闭、脑室内出血（Ⅲ、�Objective To review the trends of the rates of survival and complications in extremely preterm infants and extremely low birth weight infants （ELBWI）. Methods The clinical data of 259 extremely preterm infants （gestational age 〈28 weeks） and 239 ELBWI （birth weight 〈1 000 g） （163 cases with gestational age 〈28 weeks and birth weight 〈1 000 g）, who were discharged between January 1, 2009 and December 31, 2015, from Neonatal Intensive Care Unit of Shenzhen Maternity ＆ Child Healthcare Hospital, Southern Medical University, were collected and studied retrospectively. Grouped by gestational age and birth weight, the number of inpatients, and the rates of survival and complications were compared in pairs by trend Chi-square test.Results The median gestational age of extremely preterm infants was 27 weeks （22＋6 to 27＋6 weeks）, and the median birth weight of ELBWI was 880 g （450-998 g）. The survival rate of extremely preterm infants and ELBWI was 42.9% （9/21） in 2009, which increased to 85.3% （58/68） in 2015, with an ascending trend （χ^2 trend=21.643, P=0.001）. The cure and survival rates of 259 extremely preterm infants were 64.1% （166/259） and 71.0% （184/259）; the cure and survival rates of 239 ELBWI were 64.4% （154/239） and 70.7% （169/239）; and the cure and survival rates of 163 extremely preterm ELBWI were 62.6% （102/163） and 69.9% （114/163）, respectively. The survival rate in extremely preterm infants with gestational age 〈24 weeks was 1/7, increased to 81.4% （118/145） in those with gestational age≥27 to 〈28 weeks, showing an ascending trend with increased gestational age （χ^2trend=36.037, P=0.000）. The survival rate in ELBWI with birth weight 〈500 g was 0/2, increased to 80.7% （88/109） when birth weight was ≥900 to 〈1 000 g, with an ascending trend with increased birth weight （χ^2trend=26.505, P=0.000）. The major complications were neonatal respiratory distress syndrome [85.1%（285/335）], intraventricular h

关 键 词：婴儿 超早产 婴儿 超低出生体重 存活率 死亡率 重症监护病房 新生儿 

分 类 号：R722.6[医药卫生—儿科]