摘要
目的探讨超低出生体重儿(ELBWI)的住院、转归及其随访情况。方法选择2010年1月1日至2016年5月31日,于广西壮族自治区妇幼保健院、玉林市妇幼保健院、钦州市妇幼保健院等10家医疗机构的新生儿重症监护病房接受住院治疗的276例ELBWI为研究对象。对其临床病例资料及随访资料,进行回顾性分析,内容包括孕母及ELBWI一般临床资料,ELBWI新生儿期常见临床症状、并发症、转归及出院后随访情况等。采用χ2检验及Mann-Whitney U检验,对ELBWI出生胎龄<28周与出生胎龄≥28~32周,并存活出院者的呼吸支持治疗情况进行统计学比较。本研究遵循的程序符合2013年修订的《世界医学协会赫尔辛基宣言》要求。结果①本研究分娩ELBWI的209例孕妇中,双胎妊娠孕妇占31.6%(66/209)。这209例分娩ELBWI孕妇的前3位妊娠期并发症依次为:胎膜早破(27.3%,57/209),妊娠期高血压疾病(19.6%,41/209)及妊娠期糖尿病(17.7%,37/209)。②本研究276例ELBWI中,新生儿期前4位常见临床症状依次为:呼吸困难(91.7%,253/276),反应差(75.7%,209/276),口唇或全身青紫(67.8%,187/276)及腹胀(40.6%,112/276)。③本研究276例ELBWI中,新生儿期前6位并发症依次为:高胆红素血症(81.2%,224/276),呼吸窘迫综合征(RDS)(75.7%,209/276),早产儿贫血(64.1%,177/276),宫内感染性肺炎(50.0%,138/276),支气管肺发育不良(BPD)(48.6%,134/276)及败血症(45.7%,126/276)。④存活出院的128例ELBWI中,出生胎龄<28周ELBWI的呼吸机辅助通气治疗率及治疗时间分别为92.6%和8.0 d(3.0~16.0 d)、连续气道正压通气(CPAP)治疗率及治疗时间,分别为96.3%和16.0 d(11.0~25.0 d),均显著高于或长于出生胎龄≥28~32周者的67.2%、2.0 d(0~7.5 d)、73.4%、7.5 d(0~20.0 d),并且差异均有统计学意义(χ2=11.321、P=0.001,Z=-3.994、P<0.001,χ2=11.329、P=0.001,Z=-3.301、P=0.001)。⑤本研究276例ELBWI救治存活率为46.4%(128/276),其中88例为治愈出院,40例为好转出�
Objective To investigate the hospitalization,outcomes and follow-up results of extremely low birth weight infant(ELBWI).Methods From 1 January 2010 to 31 May 2016,a total of 276 cases of ELBWI who were hospitalized in neonatal intensive care unit of 10 medical institutions,including Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Maternal&Child Health Hospital of Yulin,Maternal&Child Health Hospital of Qinzhou,etc.,were chosen as research subjects.Clinical case data and follow-up results of the ELBWI were analyzed retrospectively,including general clinical data of ELBWI and their mothers,common clinical symptoms,complications,sequelaes and follow-up conditions of ELBWI.Among survival and discharged ELBWI,the respiratory therapy between gestational age<28 weeks and≥28-32 weeks ELBWI were compared statistically by chi-square test and Mann-Whitney U test.This study was in line with World Medical Association Declaration of Helsinki revised in 2013.Results①General informations of 209 mothers of ELBWI in this study:the twin pregnancy rate was 31.6%(66/209).Top three pregnancy complications in turn of 209 mothers were premature rupture of membrane(27.3%,57/209),gestational hypertension diseases(19.6%,41/209)and gestational diabetes mellitus(17.7%,37/209).②Top four clinical symptoms in turn of 276 cases of ELBWI in neonatal period were dyspnea(91.7%,253/276),poor response(75.7%,209/276),cyanosis of lips or whole body(67.8%,187/276)and abdominal distention(40.6%,112/276).③Top six complications in turn of 276 cases of ELBWI in neonatal period were hyperbilirubinemia(81.2%,224/276),respiratory distress syndrome(RDS)(75.7%,209/276),anemia of prematurity(64.1%,177/276),intrauterine infectious pneumonia(50.0%,138/276),bronchopulmonary dysplasia(BPD)(48.6%,134/276)and sepsis(45.7%,126/276).④Among 128 cases of ELBWI who were alive and discharged from hospitals,the rate of treatment and duration of respirator assisted ventilation of ELBWI with gestational age<28 weeks were 92.6%and 8.0 d(3.0-16.0 d),r
作者
姚丽平
蒙丹华
韦秋芬
李燕
梁武华
黄海燕
甄宏
张树英
韦毅
吴朝波
韦彦成
周俊新
卢国琇
Yao Liping;Meng Danhua;Wei Qiufen;Li Yan;Liang Wuhua;Huang Haiyan;Zhen Hong;Zhang Shuying;Wei Yi;Wu Chaobo;Wei Yancheng;Zhou Junxin;Lu Guoxiu(Department of Neonatology,Maternal & Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,First People′s Hospital of Hechi,Hechi 547000,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,Maternal & Child Health Hospital of Yulin,Yulin 537000,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,Maternal & Child Health Hospital of Qinzhou,Qinzhou 535000,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,People′s Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,Nanning Maternal & Child Health Hospital,Nanning 530003,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,Maternal & Child Health Hospital of Guilin,Guilin 541000,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,Ethnic Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,People′s Hospital of Hechi,Hechi 547000,Guangxi Zhuang Autonomous Region,China;Department of Neonatology,People′s Hospital of Bobai County,Yulin 537600,Guangxi Zhuang Autonomous Region,China)
出处
《中华妇幼临床医学杂志（电子版）》
CAS
2019年第4期444-452,共9页
Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)
基金
广西壮族自治区卫生计生委自筹经费科研课题(Z2016091、Z20170787、Z20170788、Z20170789、Z20180084)~~
关键词
住院
结局
诱发电位
听觉
脑干
视网膜病
早产儿
存活率
婴儿
超低出生体重
Hospitalization
Outcomes
Evoked potentials,auditory,brain stem
Retinopathy of prematurity
Survival rate
Infant,extremely low birth weight
