超低出生体重儿122例早期生存质量分析  

The study of quality of life of extremely low birth weight infants： an early life report of 122 cases

作　　者：刘颖钏 邬方彦[1] 印学蕾[1] 

机构地区：[1]同济大学附属上海市第一妇婴保健院新生儿科,200040

出　　处：《中华新生儿科杂志（中英文）》2018年第1期39-44,共6页Chinese Journal of Neonatology

摘　　要：目的 分析超低出生体重（extremely low birth weight,ELBW）婴儿早期存活率、死亡原因及住院期间并发症发生率.方法 选取2013年12月至2016年11月本院出生的ELBW婴儿临床资料进行回顾性分析.按出生时胎龄及体重各分为5组,分析不同组别婴儿早期存活率;根据婴儿死亡时间分为＜7d和≥7d2组,分析其直接死亡原因;按出生体重分为＜750 g和≥750 g 2组,按胎龄分为＜26周、26 ～ 27周、≥28周3组,分析各组住院期间（＜14 d和≥14 d）并发症发生率.结果 共纳入ELBW婴儿122例.平均胎龄（27.6±2.1）周,出生体重（849±112）g.胎龄和出生体重均与早期存活率成正相关.研究期间共死亡43例,其中＜7d死亡13例,死亡原因前3位分别为新生儿呼吸窘迫综合征、重度窒息和新生儿肺出血;≥7 d死亡30例,死亡原因前3位分别为败血症、支气管肺发育不良合并肺炎和新生儿坏死性小肠结肠炎.住院时间＜14 d时,所纳入的122例ELBW婴儿中胎龄＜ 26周组和26 ～ 27周组新生儿呼吸窘迫综合征发生率高于≥28周组（86.5％、94.3％比59.4％）,差异有统计学意义（P＜0.05）;出生体重＜ 750 g组新生儿重度窒息和血糖紊乱发生率高于≥750 g组（37.0％比8.4％,51.9％比24.2％）,差异有统计学意义（P＜0.05）.住院时间≥14 d后存活的99例ELBW婴儿中,胎龄＜26周组早产儿视网膜病发生率高于26 ～ 27周组和≥28周组（40.7％比18.2％、14.3％）,败血症发生率高于≥28周组（74.1％比39.3％）,差异有统计学意义（P＜0.05）;胎龄＜ 26周组和26 ～ 27周组支气管肺发育不良和贫血发生率均高于≥28周组（70.4％、68.2％比35.7％,88.9％、84.1％比57.1％）,差异均有统计学意义（P＜0.05）;出生体重＜750 g组与≥750 g组相关并发症发生率差异均无统计学意义（P＞0.05）.结论 ELBW婴儿随着胎龄和出生体重增加,存活率明显升高,并发症发生率降低,对ELBW婴儿Objective To study the survival rate,cause of death and the incidence of complications of extremely low birth weight （ELBW） infants.Method Clinical data of the ELBW infants admitted in our hospital between December 2013 and November 2016 were retrospectively analyzed.The cases were assigned into five groups based on gestational age （GA） or birth weight （BW） to further analyze the survival rates among each group.According to the time of death,the cases were assigned into two groups （death within 7 days or after 7 days） to analyze their direct death causes.ELBW infants were categorized into three groups according to GA （〈 26 weeks,26-27 weeks and ≥ 28 weeks） or into two groups according to birth weight （〈 750 g and ≥ 750 g） to analyze the incidence of complications within 14 days or after 14 days.Result A total of 122 ELBW infants were enrolled in this study.The mean GA was 27.6 ± 2.1 （range of 22-33） weeks,mean birth weight was 849 ± 112 （range of 525-995） g.GA and BW were both positively correlated with the survival rate.Among all the studied cases,43 were dead cases.Within these 43 cases,13 of them died within 7 days.The top 3 causes of death of them were neonatal respiratory distress syndrome （RDS）,severe asphyxia and pulmonary hemorrhage of neonatal.The other 30 cases died after 7 days,while the top 3 causes of death of them were sepsis,bronchopulmonary dysplasia （BPD） combined with pneumonia and neonatal necrotizing enterocolitis （NEC）.The incidences of complications of all 122 ELBW infants within 14 days of hospitalization were as follow：ELBW infants with BW 〈 750 g had higher morbidity of neonatal severe asphyxia and neonatal blood glucose disorder than ELBW infants with BW ≥ 750 g （37.0% vs.8.4%,51.9% vs.24.2%,P 〈0.05）;ELBW infants with GA 〈 26 weeks and 26-27 weeks had higher morbidity of neonatal RDS than ELBW infants with GA≥28 weeks （86.5% and 94.3% vs.59.4%,P 〈 0.05）.99 cases of ELBW infants whose duration of hospitalization w

关 键 词：婴儿 超低出生体重 存活率 死亡原因 

分 类 号：R722.6[医药卫生—儿科]