超低/极低出生体质量儿223例临床回顾分析  

Retrospective clinical analysis of 223 extremely low birth weight and very low birth weight infants

作　　者：阚清[1] 杨洋[1] 邱洁[1] 郭艳[1] 封云[1] 赵幽燕[1] 周晓光[1] 周晓玉[1] 

机构地区：[1]南京医科大学附属南京儿童医院新生儿科,江苏南京210008

出　　处：《东南大学学报（医学版）》2016年第5期713-718,共6页Journal of Southeast University(Medical Science Edition)

基　　金：南京市医学科技发展项目(YKK14120)

摘　　要：目的:总结超低出生体质量儿(extremely low birth weight infant,ELBWI)和极低出生体质量儿(very low birth weight infant,VLBWI)的临床特点及转归。方法:对本院新生儿科近2年收治的223例ELBWI/VLBWI的临床资料进行回顾性分析,总结患儿一般情况、出生情况、产前产房处理、合并症及转归。结果:(1)一般情况:223例ELBWI/VLBWI平均胎龄(30.19±0.15)周,平均出生体质量(1 224.0±12.4)g。(2)出生情况:自然受孕78.92%(176/223),辅助生育21.08%(47/223);单胎64.57%(144/223),多胎35.43%(79/223);胎膜早破32.29%(72/223),妊娠高血压20.18%(45/223),妊娠糖尿病4.04%(9/223)。(3)产前产房处理:产前使用地塞米松22.87%(51/223),无在产房使用无创正压通气病例。(4)主要合并症:新生儿呼吸窘迫综合征47.53%(106/223),支气管肺发育不良4.93%(11/223),早产儿视网膜病18.63%(19/102),动脉导管未闭26.91%(60/223),脑室内出血92.38%(206/223),败血症43.05%(96/223)。(5)转归:治愈/好转70.85%(158/223),放弃22.87%(51/223),死亡6.28%(14/223);宫外生长迟缓57.40%(128/223)。结论:ELBWI/VLBWI病例数逐年增加,减少胎膜早破、推广产前激素、应用无创辅助通气、早期筛查视网膜病、积极营养支持对于提高ELBWI/VLBWI存活率和改善预后至关重要。Objective： To analyze the clinical features and prognosis of extremely low birth weight infant（ ELBW）and very low birth weight infants（ VLBW）. Methods： Data of totally 223 hospitalized ELBWI / VLBWI in department of neonatology of our hospital were analyzed. The information of general data and births,prenatal care,complications and outcome were summarized. Results：（ 1） 223 ELBWI / VLBWI were involved,their mean gestational age was（ 30. 19 ± 0. 15） weeks,mean birth weight was（ 1224 ± 12. 35） g.（ 2） Rate of natural conception was 78. 92%（ 176 /223）,rate of in-vitro fertilization was 21. 08%（ 47 /223）. Rate of single birth was64. 57%（ 144 /223）,rate of multiple births was 35. 43%（ 79 /223）. Rate of premature rupture of membranes（ PROM） was 32. 29%（ 72 /223）,pregnancy-induced hypertension syndrome was 0. 18%（ 45 /223）,gestational diabetes mellitus was 4. 04%（ 9 /223）.（ 3） Rate of prenatal steroids exposure was 22. 87%（ 51 /223）. None of the cases were treated with continuous positive airway pressure（ CPAP） in delivery room.（ 4） Their main complication included neonatal respiratory distress syndrome（ NRDS,47. 53%,106 /223）, bronchopulmonary dysplasia（ BPD,4. 93%,11 /223）,preterm retinopathy（ ROP,18. 63%,19 /102）,patent ductus arteriosus（ PDA,26. 91%,60 /223）,intraventricular hemorrhage（ IVH,92. 38%,206 /223）,sepsis（ 43. 05%,96 /223）.（ 5） Rate of cured cases was 70. 85%（ 158 /223,treatment was given up in 22. 87%（ 51 /223）,total mortality was 6. 28%（ 14 /223）. Rate of extrauterine growth retardation（ EUGR） was 57. 40%（ 128 /223）. Conclusion： The number of ELBWI / VLBWI has increased dramatically. Reduction of PROM, antenatal steroids, noninvasive respiratory support,early screening of ROP and optimal nutrition supports are key factors of improving the survival rate and long-term outcomes of ELBWI / BLBWI.

关 键 词：超低出生体质量儿 极低出生体质量儿 临床资料 回顾性 

分 类 号：R722.6[医药卫生—儿科]