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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 related factors that affect the survival rate of extremely low birth weight infants (ELBWI) and take corresponding measures. Methods 42 cases of ELBWI were divided into three groups by body weight, and their clinical data were retrospectively analyzed. Results ELBWI survived 22 cases with a survival rate of 52% (22/42), 19 cases died, the mortality rate was 45% (19/42), and 1 case was abandoned. Survival rate increased with weight gain (P <0.01), and mortality decreased (P <0.01). The average number of days of hospital stay (33.5 ± 8.3) d, days of hospitalization decreased with weight gain (P <0.01). The main causes of ELBWI are multiple pregnancy (45%), premature rupture of membranes (29%), complications of pregnancy (19%), including pregnancy induced hypertension (17%), placental abruption ); Chronic diseases of pregnancy (7%). All ELBWIs have more than one complication. The lower the body weight, the higher the complication rate (P <0.01). The main causes of death are: neonatal respiratory distress syndrome, intracranial hemorrhage, pulmonary hemorrhage, respiratory failure, renal failure and so on. Conclusion Strengthening the perinatal care and guardianship and improving the management of pediatric ELBWI and complication are the keys to improve the survival rate of ELBWI and reduce the mortality.