不同原因导致的超早产儿临床特征分析  

Clinical characteristics of extremely preterm infants with different etiologies

作　　者：夏磊[1] 张樱彦 程慧清[1] 李娇 吕荣吉 赵家文 徐发林[1] Xia Lei;Zhang Yingyan;Cheng Huiqing;Li Jiao;Lyu Rongji;Zhao Jiawen;Xu Falin(Department of Neonatology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Obstetrics,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第三附属医院新生儿科,郑州450052 [2]郑州大学第三附属医院产科,郑州450052

出　　处：《中华新生儿科杂志（中英文）》2024年第7期396-401,共6页Chinese Journal of Neonatology

基　　金：河南省医学科技攻关联合共建项目(LHGJ20220540)。

摘　　要：目的:探讨不同原因导致的超早产儿临床特征。方法:选取2016年1月至2022年12月在郑州大学第三附属医院出生并入住新生儿重症监护室的超早产儿进行回顾性分析,收集母亲孕期及患儿临床资料,根据导致超早产的原因分为胎膜早破超早产组、自发性超早产组及医源性超早产组,应用SPSS 26.0统计软件分析各组的临床特征。结果:共纳入467例超早产儿,其中胎膜早破超早产组133例(28.5%),自发性超早产组160例(34.3%),医源性超早产组174例(37.2%)。胎膜早破超早产组母亲生殖道感染、羊水异常、早发型败血症及超早产儿存活比例最高(P<0.05);自发性超早产组胎龄更小,足疗程应用糖皮质激素的比例更低,双/多胎妊娠、Ⅲ~Ⅳ级呼吸窘迫综合征发生率最高(P<0.05);医源性超早产组剖宫产、肺表面活性物质重复使用比例最高(P<0.05)。存活超早产儿共245例,其中自发性超早产组剖宫产、足疗程应用糖皮质激素比例更低,双/多胎比例更高(P<0.05)。结论:不同原因导致的超早产儿临床特征不同,胎膜早破超早产组更需要关注早期感染问题,但存活率最高;自发性超早产组双/多胎比例更高;医源性超早产组更需关注肺发育、呼吸窘迫综合征情况。Objective To study the clinical characteristics of extremely premature infants(EPIs)with different etiologies.Methods From January,2016 to December,2022,EPIs born in our hospital were retrospectively selected and the clinical data of the infants and their mothers were collected.According to different etiologies of prematurity,the infants were assigned into three groups:premature rupture of the membranes(PROM)group,spontaneous preterm(SP)group and iatrogenic preterm(IP)group.The clinical characteristics of these groups were compared using SPSS 26.0 statistical software.Results A total of 467 EPIs were enrolled,including 133(28.5%)in PROM group,160(34.3%)in SP group and 174(37.2%)in IP group.PROM group showed the highest incidences of maternal genital tract infections,amniotic fluid anomalies,early-onset sepsis and preterm survival rates(all P<0.05).SP group had smaller gestational age,lower proportion of full-course prenatal glucocorticoid use,higher incidences of twin/multiple births and gradeⅢ~Ⅳneonatal respiratory distress syndrome(P<0.05).IP group had the highest incidences of C-section,multiple doses of pulmonary surfactant(P<0.05).245 EPIs survived and the surviving IP group had the lowest incidences of C-section,full-course glucocorticoid use and highest rate of twin/multiple births(P<0.05).Conclusions EPIs with different etiologies have different clinical characteristics.PROM group has higher incidences of maternal genital tract infections,amniotic fluid abnormalities and early-onset sepsis with higher survival rates.SP group has lower rates of C-section and higher rates of twin/multiple births.IP group may need multiple doses of pulmonary surfactant and careful monitor of neonatal respiratory distress syndrome.

关 键 词：超早产儿 胎膜早破 自发性早产 医源性早产 

分 类 号：R722.6[医药卫生—儿科]