118例超/极低出生体重儿临床分析  

Clinical Analysis of 118 Cases of Ultra-low Birth Weight Infants

作　　者：曹庭[1] 潘晓琴[1] CAO Ting;PAN Xiao-qin(Department of Neonatology,First People's Hospital of Changde City,Changde,Hunan Province,415000 China)

机构地区：[1]湖南省常德市第一人民医院新生儿科,湖南常德415000

出　　处：《中外医疗》2020年第36期44-47,共4页China & Foreign Medical Treatment

摘　　要：目的分析超/极低出生体重儿(ELBWI/VLBWI)产科高危因素、并发症及预后情况,为ELBWI/VLBWI的防治及管理提供临床依据。方法方便选取2018年5月—2019年4月常德市第一人民医院收治的ELBWI/VLBWI共118例的临床资料,回顾性分析其高危因素,并发症及预后。结果共收集病例118例,其中胎龄<28周组13例,28~31+6周80例,胎龄≥32周25例;出生体重<1000 g 17例,1000~1249 g 36例,1250~1500 g 65例;ELBWI/VLBWI产科高危因素前5位为:胎膜早破67例(56.78%),双胎41例(34.75%),试管婴儿32例(27.12%),高龄产妇24例(20.34%),子痫前期18例(15.25%)。ELBWI/VLBWI并发症前5位为:肺炎(72例,61.02%)、NRDS(70例,59.32%)、窒息(64例,54.24%)、贫血(61例,51.69%)、BPD(41例,34.75%)。胎龄越小,体重越低,窒息、贫血、BPD,呼吸暂停,喂养不耐受发生率越高(按胎龄分组χ^(2)=13.314、13.671、22.149、22.345、10.403,P<0.05;按体重分组χ^(2)=12.963、6.327、16.987、14.905、8.095,P<0.05)。低血糖在胎龄≥32周组发生率较高。118例患儿存活108例,死亡10例,病死率为8.47%。ELBWI存活率为88.24%,VLBWI存活率为92.08%。引起死亡的主要原因为NRDS、BPD及晚发败血症(LOS)。结论加强围生期保健,避免产科高危因素,有助于降低早产儿出生率;早产儿胎龄及出生体重与并发症发生率有关;积极防治并发症,有利于提高ELBWI/VLBWI生存率及生存质量。Objective To analyze the obstetric high-risk factors,complications and prognosis of ultra-low birth weight infants(ELBWI/VLBWI),and to provide clinical evidence for the prevention and management of ELBWI/VLBWI.Methods conveniently selected the clinical data of 118 ELBWI/VLBWI patients admitted to Changde First People's Hospital from May 2018 to April 2019,and retrospectively analyzed their high-risk factors,complications and prognosis.Results A total of 118 cases were collected,including 13 cases in the gestational age group<28 weeks,80 cases in the 28-31+6 weeks group,25 cases in the gestational age group ≥32 weeks;17 cases in the birth weight<1000 g,36 cases in the 1000-1249 g group,65 cases in the 1250-1500 g group;the top five high-risk factors in obstetrics for ELBWI/VLBWI are:67 cases(56.78%)of premature rupture of membranes,41 cases(34.75%)of twins,32 cases(27.12%)of IVF,and 24 cases(20.34%)of advanced mothers,18 cases of preeclampsia(15.25%).The top five complications of ELBWI/VLBWI are:pneumonia(72 cases,61.01%),NRDS(70 cases,59.32%),asphyxia(64 cases,54.24%),anemia(61 cases,51.69%),BPD(41 cases,34.75%).The younger the gestational age,the lower the weight,the higher the incidence of asphyxia,anemia,BPD,apnea,and feeding intolerance(According to gestational age χ^(2)=13.314,13.671,22.149,22.345,10.403,P<0.05;by body weight χ^(2)=12.963,6.327,16.987,14.905,8.095,P<0.05).The incidence of hypoglycemia was higher in the gestational age≥32 weeks group.108 of the 118 children survived,10 died,and the mortality rate was 8.47%.The survival rate of ELBWI was 88.24%,and the survival rate of VLBWI was 92.08%.The main causes of death are NRDS,BPD,and late onset sepsis(LOS).Conclusion Strengthening perinatal care and avoiding obstetric high-risk factors can help reduce the birth rate of premature infants;gestational age and birth weight of premature infants are related to the incidence of complications;active prevention and treatment of complications is beneficial to improve the survival rate and survival of ELB

关 键 词：超低出生体重儿 极低出生体重儿 高危因素 并发症 

分 类 号：R4[医药卫生—临床医学]