摘要
目的 探讨影响极低出生体重儿 (extremelylowbirthweightinfant,ELBWI)存活率的相关因素 ,以采取相应措施。 方法 将 4 2例ELBWI按体重分为三组 ,并对其临床资料进行回顾性分析。 结果 ELBWI出院时存活 2 2例 ,存活率 5 2 % (2 2 /4 2 ) ;死亡 19例 ,病死率 4 5 % (19/4 2 ) ,放弃 1例。存活率随体重增加而增高 (P <0 .0 1) ,病死率则下降 (P <0 .0 1)。存活者平均住院天数 (33.5± 8.3)d ,住院天数随体重增加而缩短 (P <0 .0 1)。引起ELBWI的主要原因是 :多胎妊娠 (4 5 % ) ;胎膜早破 (2 9% ) ;妊娠并发症 (19% ) ,包括妊娠高血压综合征 (17% )、胎盘早剥 (2 % ) ;妊娠期慢性疾病(7% )。全部ELBWI均存在一种以上并发症。其体重越低并发症发生率越高 (P <0 .0 1)。死亡主要原因是 :新生儿呼吸窘迫综合征、颅内出血、肺出血、呼吸循环衰竭、肾功能衰竭等。 结论 加强围产期保健与监护 ,提高儿科对ELBWI管理及并发症的处置水平 ,是提高ELBWI存活率、降低病死率的关键。
Objective To investigate the potential factors affecting the survival rate of extremely low birth weight infant (ELBWI) and to make out a practical strategy. Methods Fourty-four ELBWI were devided to 3 groups according to their birth weight. All the clinical data were reviewed. Results The survival rate on discharge was 52% (22/42) and the mortality rate was 45%(19/42). The survival rate was significantly increased with higher birth weight( P <0.01), and less complication( P <0.01) The mortality was attenuated negatively with factors mentioned-above. The average hospital stay was (33.5±8.3) days. The main causes of ELBWI were possibly multiple gestation (45%), premature rupture of membrane (29%), and pregnant complications (19%) such as pregnancy induced hypertension 17%, placental abruption 2%, and chronic diseases 7%. All the ELBWI had at least one complication, its morbidity seemed much higher in those with lower birth weight, small gestational age. The main causes of death were RDS, intracranial hemorrhage, pulmonary hemorrhage, respiratory failure, heart failure, renal failure, and so on. Conclusion To improve the perinatal health care and surveillance and the management of ELBWI and complications seems to be effective and crucialin improving the survival rate and reducing mortality.
出处
《中华围产医学杂志》
CAS
2004年第4期233-235,共3页
Chinese Journal of Perinatal Medicine