出生体重不一致双胎儿住院期间并发症回顾性分析  

A retrospective analysis of complications during hospitalization in twins with birth weight discordance

作　　者：李雪 谭小华[1] 石碧君 陈倩[1] 张勇[1] 潘振 蔡子聪 贾春宏 崔其亮[1] Xue Li;Xiaohua Tan;Bijun Shi;Qian Chen;Yong Zhang;Zhen Pan;Zicong Cai;Chunhong Jia;Qiliang Cui(Department of Neonatology,Third Affiliated Hospital of Guangzhou Medical University,Guangzhou 510150,China)

机构地区：[1]广州医科大学附属第三医院新生儿科,广州510150

出　　处：《中华新生儿科杂志（中英文）》2023年第11期655-659,共5页Chinese Journal of Neonatology

基　　金：广东省医学科研基金(B2019018);广州市卫生健康科技项目西医类一般引导项目(20231A011087,20231A011093)。

摘　　要：目的探讨出生体重不一致双胎新生儿住院期间并发症发生情况。方法选择2011年1月至2020年12月在广州医科大学附属第三医院产科出生并于新生儿重症监护室住院的双胎儿的临床资料进行回顾性研究。根据出生体重差异(birth weight discordant,BWD)分组,BWD>15%为双胎出生体重不一致(birth weight discordant twins,BWDT)组,BWD≤15%为双胎出生体重一致(birth weight concordant twins,BWCT)组。比较两组双胎儿住院期间并发症发生情况。结果共纳入1546对双胎儿,其中BWDT组486对(31.4%),BWCT组1060对(68.6%)。BWDT组肺表面活性物质使用率(47.7%比42.2%)、持续气道正压通气时长≥24 h(40.5%比35.0%)、经鼻高流量氧疗时长≥24 h(22.8%比16.3%)比例及新生儿呼吸窘迫综合征(52.9%比47.1%)、支气管肺发育不良(15.6%比11.1%)、持续肺动脉高压(3.1%比1.4%)和贫血(79.6%比70.1%)发生率均高于BWCT组,差异有统计学意义(P<0.05);BWDT组肺出血(OR=2.036,95%CI 1.119~3.703,P=0.020)和支气管肺发育不良(OR=2.960,95%CI 1.656~5.219,P=0.010)的发生风险高于BWCT组。结论BWDT双胎儿住院期间并发症发生率高于BWCT双胎儿。Objective To study the incidences of complications in twins with birth weight discordance(BWD)during hospitalization.Methods From January 2011 to December 2020,twins born in the Department of Obstetrics and hospitalized in NICU of our hospital were retrospectively studied.Twins with BWD>15%were assigned into BWDT group and BWD≤15%into twins with birth weight concordant(BWCT)group.Complications during hospitalization were compared between the two groups.Results A total of 1546 pairs of twins were enrolled,including 486(31.4%)in BWDT group and 1060(68.6%)in BWCT group.Compared with BWCT group,BWDT group had significantly higher incidences of pulmonary surfactant(PS)utilization(47.7%vs.42.2%),continuous positive airway pressure≥24 h(40.5%vs.35.0%),high-flow nasal cannula≥24 h(22.8%vs.16.3%),neonatal respiratory distress syndrome(52.9%vs.47.1%),bronchopulmonary dysplasia(BPD)(15.6%vs.11.1%),persistent pulmonary hypertension of the newborn(3.1%vs.1.4%)and anemia(79.6%vs.70.1%)(all P<0.05).After adjusting for confounding factors,the risks of pulmonary hemorrhage(OR=2.036,95%CI 1.119-3.703,P=0.020)and BPD(OR=2.960,95%CI 1.656-5.219,P=0.010)in BWDT group were higher than BWCT group.Conclusions BWD twins has higher incidences of complications during hospitalization than BWC twins.

关 键 词：双胎儿 出生体重不一致 新生儿 并发症 发病率 

分 类 号：R47[医药卫生—护理学]