不同胎龄和出生体重早产儿的并发症及其结局探讨

Preterm infantile morbidity and mortality according to different gestational age and birth weight

目的探讨早产儿并发症的发生和结局与胎龄、出生体重的关系。方法对我院1995年1月至2004年12月共1882例住院早产儿临床资料进行回顾性分析。结果早产儿死亡率3．3％（62／1882），随胎龄和出生体重的增加，死亡率下降。胎龄〈32周者肺透明膜病死亡率高。早产儿并发症发生率为49．5％（932／1882），并发症主要发生于胎龄〈32周或出生体重〈1500g的极低出生体重儿，以肺透明膜病、窒息和呼吸暂停为主。胎龄32周以上或出生体重〉1500g的早产儿并发症发生率降低。结论加强孕期管理降低极低出生体重儿的发生率，对可能早产者积极应用肾上腺皮质激素促胎肺成熟、出生后采取正确有效的复苏抢救措施、预防窒息发生，及早补充肺表面活性物质，将有助于降低早产儿并发婴儿症发病率和死亡率，改善其预后。

Objective To evaluate the influence of gestational age and birth weight on preterm infantile morbidity and mortality. Methods A retrospective cohort study was performed. Data from 1882 live preterm infants born in our hospital from Jan. 1995 to Dec. 2004 were reviewed to analyze morbidity and mortality according to gestational age and birth weight. Results A total of 3.3 % （62/ 1882） of preterm infants died before hospital discharge. Preterm infantile mortality was significantly higher in the infants born at 28-30 gestational weeks and whose birth weight 〈1000 g. Most preterm infants 〈32 gestational age died of hyaline membrane disease. And 932 out of the 1882 （49. 5%） preterm infants had at least one complications. A large number of them were very low birth weight infants suffered from hyaline membrane disease, asphyxia and apnea. The morbidity and mortality of preterm infants descended with the increase of gestational age and birth weight. Conclusions Preterm infantile morbidity and mortality can be reduced by active prenatal management, supplementation of adrenal cortical hormone and pulmonary surfactant in time, and effective resuscitation.