极早产小于胎龄儿临床特点分析  

Clinical Features of Very Preterm Small-for-gestational-age Infants

作　　者：郭名颜 童玲 王慧琴 GUO Ming-yan;TONG Ling;WANG Hui-qin(Department of Neonatal,Affiliated Maternal and Child Health Hospital of Anhui Medical University/Anhui Maternal and Child Health Hospital,Hefei 230001,Anhui,China)

机构地区：[1]安徽医科大学附属妇幼保健院/安徽省妇幼保健院新生儿科,安徽合肥230001

出　　处：《医学信息》2023年第1期99-102,共4页Journal of Medical Information

基　　金：合肥市卫生健康应用医学研究项目(编号:Hwk2021zd015)。

摘　　要：目的探讨极早产小于胎龄儿(SGA)的临床特点。方法收集2017年11月-2021年12月收治的将32例SGA作为SGA组,另抽取同期出生的55名极早产适于胎龄儿(AGA)设为AGA组。比较两组患儿的一般情况、住院期间并发症及生后6 h内、6~7 d及14 d时部分实验室指标。结果在生后6 h内SGA组血小板、中性粒细胞计数、血糖、高密度脂蛋白(HDL)较AGA组低,而血红蛋白高于AGA组,差异有统计学意义(P<0.05);SGA组在生后6 h内、6~7 d及14 d时的甘油三酯均高于AGA组,总胆固醇、低密度脂蛋白在生后14 d较AGA组高,差异有统计学意义(P<0.05);SGA组血清磷在生后6 h内、6~7 d较AGA组更低,血钙在生后6~7 d高于AGA组(P<0.05);SGA组住院期间喂养不耐受、低钾血症、低镁血症、败血症、支气管肺发育不良(BPD)的发生率更高,差异有统计学意义(P<0.05)。结论SGA中性粒细胞计数,血小板计数较低,加上住院时间久,住院期间感染的发生率更高,易发生再喂养综合征,引起低磷、低镁、低钾血症。因此,在出生体重小于P10的极早产儿入院时应密切监测其临床变化和实验室指标,以便及早发现感染和电解质紊乱等并发症发生,及早诊断和治疗以改善预后,提高SGA生存率。Objective To explore the clinical features of very preterm small-for-gestational-age(SGA)infants.Methods From November 2017 to December 2021,32 cases of SGA were collected as SGA group,and 55 very premature infants of appropriate gestational age(AGA)born in the same period were selected as AGA group.The general condition,complications during hospitalization and some laboratory indexes within 6 h,6-7 d and 14 d after birth were compared between the two groups.Results The number of platelets,neutrophils,blood glucose and high density lipoprotein(HDL)in SGA group were lower than those in AGA group within 6 hours after birth,while hemoglobin was higher than that in AGA group,the difference was statistically significant(P<0.05).The triglycerides in the SGA group were higher than those in the AGA group within 6 h,6-7 d and 14 d after birth,and the total cholesterol and low density lipoprotein were higher than those in the AGA group at 14 d after birth,the difference was statistically significant(P<0.05).Serum phosphorus in SGA group was lower than that in AGA group within 6 h and 6-7 d after birth,and serum calcium was higher than that in AGA group at 6-7 d after birth(P<0.05).The incidence of feeding intolerance,hypokalemia,hypomagnesemia,sepsis,and bronchopulmonary dysplasia(BPD)was higher in the SGA group during hospitalization,,the difference was statistically significant(P<0.05).Conclusion The number of neutrophils and platelets in SGA is low,and the incidence of infection during hospitalization is higher due to the long hospitalization time,which is prone to refeeding syndrome and causes low phosphorus,low magnesium and hypokalemia.Therefore,the clinical changes and laboratory indicators of very preterm infants with birth weight less than P10 should be closely monitored when they are admitted to hospital,so as to detect complications such as infection and electrolyte disorders early,diagnose and treat early to improve the prognosis and improve the survival rate of SGA.

关 键 词：小于胎龄儿 极早产儿 实验室指标 感染 电解质紊乱 再喂养综合征 

分 类 号：R722.6[医药卫生—儿科]