231例极低/超低出生体重儿住院情况回顾性分析  

Retrospective Analysis on the Treatment of 231 Cases of Very Low or Extremely Low Birth Weight Infants

作　　者：张漪[1] 陈样[1] 夏世文[1] 

机构地区：[1]湖北省妇幼保健院新生儿科,湖北武汉430070

出　　处：《武汉大学学报（医学版）》2016年第6期990-994,共5页Medical Journal of Wuhan University

摘　　要：目的:探讨2009年及2014年极低出生体重儿(VLBWI)和超低出生体重儿(ELBWI)住院情况及治疗效果的变化与进步。方法:以湖北省妇幼保健院新生儿科作为单中心进行研究,回顾性分析该院新生儿重症监护室(NICU)2014年住院的100例(A组)出生体重<1 500g患儿围产期情况、营养、呼吸支持治疗、合并症、结局等方面在内的住院信息,并与2009年在该中心住院的131例同类患儿(B组)相关信息进行比较,分析5年间2组患儿各项资料及住院结局的变化。结果:A组出生胎龄为(30.7±2.4)周;出生体重(1 278.1±142.1)g;男女比为1.94,与B组相比没有显著差异。A组双胎或多胎的比率(53%vs.44%,P<0.01)、产前激素使用率(26%vs.7.6%,P<0.01)、进入母婴同室的人数(44%vs.25%,P<0.01)及母婴同室中体重增长速度(24.1±13.4 vs.11.7±14.6,P<0.01)、肺泡表面活性物质(PS)使用率(32%vs.13.7%,P<0.01)、机械通气时间(5dvs.2d,P<0.01)、外周中心静脉置管(PICC)使用率(63%vs.13%,P<0.01)、动脉导管未闭(PDA)(36%vs.18.3%,P<0.01)、早产儿视网膜病(ROP)(13%vs.3.8%,P<0.05)及支气管肺发育不良(BPD)发生率(20%vs.5.3%,P<0.05)、住院天数(40dvs.21d,P<0.01)及住院费用(47 229元人民币vs.26 194元人民币,P<0.01)等方面均显著高于B组。A组出院体重、治愈及好转率均较B组有显著提高。结论:在过去的5年中,虽然在早产儿的治疗方法及效果上有很大提高,但在产前激素使用率、呼吸管理、营养管理、院内感染防治等方面仍存在不足,需要有针对性的改进,以期望可进一步降低并发症的发生率及死亡率。Objective：To investigate 231 cases from 2009 to 2014among very low birth weight infants（VLBWI）and extremely low birth weight infants（ELBWI）,and to summarize the changes of therapeutic effects.Methods：In the Newborn Center of the maternal and Child Health Hospital of Hubei Province as a single center,we retrospectively analyed 100 infants with birth weight1500grams（group A）in the neonatal intensive care unit（NICU）in 2014,including their perinatal conditions,nutrition,respiratory support treatment,complications,outcomes information and other aspects.131 cases of infants with similar condition（group B）in 2009 in the center of were compared with relevant information to analyze the changes of hospitalization information and outcomes in the past 5years.Results：In group A,the gestational age was（30.7±2.4）weeks;birth weight（1 278.1±142.1）g;Male to female ratio was 1.94,while these data were similar to those in Group B.The proportion of twins or multiple births of group A（53% vs.44%,P〈0.01）,antenatal steroid usage（26% vs.7.6%,P〈0.01）,the number of rooming（44% vs.25%,P〈0.01）and rooming-in rate of weight gain（24.1±13.4 vs.11.7±14.6,P〈0.01）,pulmonary surfactant（PS）utilization rate（32% vs.13.7%,P〈0.01）,duration of mechanical ventilation（5days vs.2days,P〈0.01）,peripherally inserted central catheter（PICC）utilization rate（63%vs.13%,P〈0.01）,patent ductus arteriosus（PDA）（36% vs.18.3%,P〈0.01）,retinopathy of prematurity（ROP）（13%vs.3.8 %,P〈0.05）and bronchopulmonary dysplasia（BPD）incidence（20% vs.5.3%,P〈0.05）,length of stay in hospital（40days vs.21 days,P〈0.01）and hospital costs（47 229 RMB vs.26 194 RMB,P〈0.01）were significantly higher than those in group B.Also the hospital discharge weight,cure and improvement rate in group A were significantly improved than in group B.Conclusion：In the past 5years,although it had greatly improved in the diagnosis method and therapeutic effect for premature infants,grea

关 键 词：极低出生体重儿 超低出生体重儿 住院情况 

分 类 号：R720.597[医药卫生—急诊医学]