周雨露,胡扬,陈晓霞
ZHOU Yulu,HU Yang,CHEN Xiaoxia

• 1:贵州医科大学临床医学院
• 2:贵州医科大学附属医院新生儿科

摘要(Abstract)：

目的分析不同胎龄低出生体重儿[极低出生体重儿(VLBWI)和超低出生体重儿(ELBWI)]风险性疾病的发生、治疗和转归。方法 248例VLBWI和ELBWI患儿根据胎龄不同分为超早产儿组(胎龄<28周,n=30)、极早产儿组(胎龄28周≤～<32周,n=157)、中期早产儿组(胎龄32周≤～<34周,n=39)及晚期早产儿组(胎龄34周≤～<37周,n=22),收集各组患儿风险性疾病[新生儿贫血、新生儿呼吸窘迫综合征(NRDS)、支气管肺发育不良(BPD)、新生儿肺炎、颅内出血、弥散性血管内凝血(DIC)、病理性黄疸、新生儿窒息]发生情况和临床信息资料[性别、胎龄、出生体质量、1 min及5 min时的Apgar评分、肺表面活性物质(PS)使用、呼吸机辅助通气使用、有创或无创呼吸机使用、抗生素使用时间、静脉营养使用时间、住院时间及治疗转归等]。结果不同胎龄的VLBWI和ELBWI患儿平均出生体质量随胎龄增加而增加(P <0.001),常见风险性疾病前4位为新生儿贫血、新生儿肺炎、NRDS及颅内出血,风险疾病的发病率随着胎龄增加而降低(P <0.001);随胎龄增加,VLBWI和ELBWI患儿PS使用率、有创呼吸机使用率、抗生素使用及住院时间均减少(P <0.05),治疗有效率升高(P <0.01)。结论新生儿贫血、新生儿肺炎、NRDS及颅内出血是VLBWI和ELBWI患儿最常见的风险性疾病,且胎龄越小其发病率越高、预后越差。
Objective To analyze the incidence,treatment and outcome of risk diseases in low birth weight infants of different gestational age [inculude very low birth weight infants(VLBWI) and extremely low birth weight infants(ELBWI) ]. Methods A total of 248 cases of VLBWI and ELBWI were selected and divided into four groups: extremely preterm infant group(gestational age < 28 weeks,n = 30),very preterm infant group(gestational age 28 weeks ≤-< 32 weeks,n = 157),moderate preterm infants group(gestational age 32 weeks≤-< 34 weeks,n = 39) and late preterm infant group(gestational age 34 weeks≤-< 37 weeks,n = 22) according to gestational age. Collect 4 groups of infants with risk of disease [neonatal respiratory distress syndrome(NRDS),bronchopulmonary dysplasia(BPD), neonatal pneumonia, intracranial hemorrhage, disseminated intravascular coagulation(DIC),pathological jaundice,newborn asphyxia] incidence and clinical information [gender,gestational age,birth weight,1-minute and 5-minute Apgar score,use of pulmonary surfactant(PS),use of ventilator assisted ventilation,use of invasive or non-invasive ventilator,duration of antibiotics use,duration of intravenous nutrition use,length of hospital stay and treatment outcomes. Results The average birth weight of the four groups of VLBWI and ELBWI increased with gestational age. The top four common risk diseases of VLBWI and ELBWI were:neonatal anemia, neonatal pneumonia, neonatal respiratory distress syndrome and intracranial hemorrhage,and with the increase of gestational age,the morbidity of neonatal anemia,neonatal pneumonia,neonatal respiratory distress syndrome,intracranial hemorrhage and bronchopulmonary dysplasia of VLBWI and ELBWI decreased.(P < 0. 001). With the increase of gestational age,the use rate of PS,the use rate of invasive ventilator,the days of antibiotic use and the length of hospital stay of VLBWI and ELBWI all decreased(P < 0. 05),the efficiency of treatment increased,and the te inefficiency of treatment decreased(P < 0. 01). Conclusions Neonatal anemia, neonatal pneumonia,NRDS,and intracranial hemorrhage are the most common risk diseases in VLBWI and ELBWI,and the younger the gestational age,the higher the incidence,and the worse the prognosis.

关键词(KeyWords)： 婴儿,极低出生体重;婴儿,超低出生体重;发病率;风险性疾病;治疗;转归
infant,very low birth weight(VLBWI);infant,extremely low birth weight(ELBWI);incidence;risk diseases;treatment;prognosis

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生健康委科技技术基金项目(gzwjkj2020-1-142)

作者(Author): 周雨露,胡扬,陈晓霞
ZHOU Yulu,HU Yang,CHEN Xiaoxia

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