不同胎龄早产儿发生病因及临床结局分析  

Analysis of the Etiology and Clinical Outcomes of Premature Infants of Different Gestational Ages

作　　者：梅玮[1] 刘东梅[1] 郝娟[1] MEI Wei;LIU Dongmei;HAO Juan(Department of Neonatology,the First People's Hospital of Bengbu City,Bengbu,Anhui 233000,China)

机构地区：[1]蚌埠市第一人民医院新生儿科,安徽蚌埠233000

出　　处：《临床误诊误治》2024年第21期62-66,共5页Clinical Misdiagnosis & Mistherapy

基　　金：2017年秦皇岛市市级科技计划(201703A130)。

摘　　要：目的总结75例不同胎龄早产儿发生病因及预后转归,以提高早产儿生存质量。方法回顾性选取2012年1月至2022年2月出生的75例早产儿作为研究对象,按照胎龄分为早期组(28~<34周)21例和晚期组(34~<37周)54例。统计不同时期早产儿早产病因、不同时期早产儿并发症、不同出生体质量早产儿并发症情况。结果早期组病因主要为未足月胎膜早破[42.86%(9/21)]、妊娠期高血压[14.29%(3/21)];晚期组病因主要为未足月胎膜早破[37.04%(20/54)]、瘢痕子宫[16.67%(9/54)]、胎盘早剥/前置[11.11%(6/54)]。早期组早产儿呼吸窘迫综合征(NRDS)、颅内出血、高胆红素血症、硬肿症、呼吸暂停、呼吸衰竭、窒息、肺炎发生率高于晚期组(P<0.05,P<0.01);出生体质量<1500 g早产儿凝血功能障碍、脓毒症、缺氧缺血性脑病、NRDS、颅内出血、高胆红素血症、硬肿症、呼吸暂停、呼吸衰竭发生率高于出生体质量1500~<2500 g早产儿(P<0.05,P<0.01)。结论不同胎龄早产儿早产病因有所差别,胎龄越小、出生体质量越轻,早产儿并发症发生风险越高,临床应早期识别早产病因并及时采取相应防治措施以延长孕周,减少并发症,改善临床结局。Objective To summarize the etiology and prognosis and outcome of 75 preterm infants of different gestational ages,so as to improve the quality of life of preterm infants.Methods Seventy-five preterm infants born from January 2012 to February 2022 were retrospectively selected and divided into early group(28-<34 weeks,n=21)and advanced group(34-<37 weeks,n=54)according to gestational age.The causes of preterm birth and complications of premature infants of different gestational ages,and complications of premature infants with different birth weight were analyzed.Results In the early group,the main causes were preterm premature rupture of membrane(PPROM)[42.86%(9/21)]and hypertension during pregnancy[14.29%(3/21)].In the advanced group,the main causes were PPROM[37.04%(20/54)],scarred uterus[16.67%(9/54)],and placental abruption/previa[11.11%(6/54)].The incidence of neonatal respiratory distress syndrome(NRDS),intracranial hemorrhage,hyperbilirubinemia,scleredema,apnea,respiratory failure,asphyxia and pneumonia in early group was higher than that in advanced group(P<0.05,P<0.01).The incidence of coagulation dysfunction,sepsis,hypoxic-ischemic encephalopathy,NRDS,intracranial hemorrhage,hyperbilirubinemia,scleredema,apnea and respiratory failure in preterm infants with birth weight<1500 g was higher than that in preterm infants with birth weight 1500-<2500 g(P<0.05,P<0.01).Conclusion The causes of preterm birth in preterm infants of different gestational ages vary.The smaller the gestational age and the lower the birth weight,the higher the risk of complications of preterm infants.Early identification of the causes of preterm birth and timely implementation of corresponding prevention and treatment measures should be carried out in clinical practice to prolong gestational age,reduce complications,and improve clinical outcomes.

关 键 词：婴儿 早产 胎膜早破 高血压 妊娠性 前置胎盘 胎盘早剥 呼吸窘迫综合征 新生儿 高胆红素血症 新生儿 脓毒症 

分 类 号：R722[医药卫生—儿科]