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目的初步探讨极低出生体重儿(VLBWI)的产科高危因素、临床并发症的发生情况。方法回顾性分析湖南省妇幼保健院2009年1月-2012年12月收治的233例VLBWI的一般情况、母孕期情况及临床并发症发生情况。结果极低出生体重儿常见产科高危因素为多胎妊娠92例(39.5%)、子痫前期76例(32.6%)、胎膜早破64例(27.5%)、妊娠期糖尿病18例(17.2%)、胎盘早剥18例(7.7%)、妊娠期慢性疾病16例(6.9%)、ICP15例(6.4%)、生殖道畸形10例(4.3%)。住院患儿常见并发症为新生儿贫血156例(67.0%)、新生儿败血症124例(53.2%)、消化道出血喂养困难104例(44.6%)、呼吸暂停80例(34.3%)、新生儿特发性呼吸窘迫综合征32例(13.7%)、新生儿休克24例(10.3%)、新生儿窒息20例(8.6%)、颅内出血20例(8.6%)。结论多胎妊娠、子痫前期、胎膜早破、妊娠期糖尿病等为发生VLBWI的产科主要高危因素。新生儿贫血、新生儿败血症、呼吸暂停、消化道出血喂养困难、新生儿特发性呼吸窘迫综合征等依为其常见并发症。加强高危妊娠监测,预防极低出生体重儿的发生,早期发现与及时处理并发症是改善VLBWI预后的根本措施。
Objective To investigate the risk factors of obstetric diseases and the incidence of clinical complications in very low birth weight infants (VLBWI). Methods Retrospective analysis of the general situation of 233 cases of VLBWI admitted in Hunan Provincial Maternal and Child Health Hospital from January 2009 to December 2012, the situation during pregnancy and the incidence of clinical complications. RESULTS: The common obstetric risk factors for very low birth weight infants were 92 (39.5%) multiple pregnancies, 76 (32.6%) preeclampsia, 64 (27.5%) premature rupture of membranes and 18 (17.2%) gestational diabetes mellitus , 18 cases of placental abruption (7.7%), 16 cases of chronic pregnancy disorders (6.9%), ICP15 cases (6.4%) and genital tract deformity in 10 cases (4.3%). Common complications in hospitalized children were neonatal anemia in 156 cases (67.0%), neonatal sepsis in 124 cases (53.2%), gastrointestinal bleeding difficulties in 104 cases (44.6%), apnea in 80 cases (34.3% 32 cases (13.7%) of idiopathic respiratory distress syndrome, 24 cases (10.3%) of newborn shock, 20 cases of neonatal asphyxia (8.6%) and 20 cases of intracranial hemorrhage (8.6%). Conclusion Multiple pregnancy, preeclampsia, premature rupture of membranes, gestational diabetes mellitus are the main obstetric risk factors for VLBWI. Neonatal anemia, neonatal sepsis, apnea, gastrointestinal bleeding difficulties, neonatal idiopathic respiratory distress syndrome, according to its common complications. To strengthen the monitoring of high-risk pregnancies to prevent the occurrence of very low birth weight infants, early detection and timely treatment of complications is the fundamental measure to improve the prognosis of VLBWI.