早产儿胃肠功能障碍的临床研究

Study of Gastrointestinal Dysfunction in Premature Infants

目的探讨早产儿胃肠功能障碍的发生率、发病因素及预后。方法分析206例早产儿不同出生体质量及胎龄与胃肠功能障碍发生率的关系。比较早产儿在合并窒息、感染情况下胃肠功能障碍的发生率。检测早产儿胃肠功能障碍组及非胃肠功能障碍组乳酸(LAC)水平,计算2组病死率。结果 206例早产儿胃肠功能障碍的发生率为21.36%(44/206例)。低出生体质量儿与极低出生体质量儿胃肠功能障碍的发生率比较差异有统计学意义(2χ=13.598,P=0.000 2);胎龄≤32周的早产儿与胎龄>32周的早产儿胃肠功能障碍的发生率比较差异有统计学意义(2χ=6.904,P=0.009 0);出生后有窒息史及合并感染的早产儿胃肠功能障碍的发生率均明显升高(Pa<0.01)。胃肠功能障碍组早产儿LAC水平明显高于非胃肠功能障碍组(t=32.849,P<0.001),且2组病死率比较差异有统计学意义(2χ=6.032,P=0.014 0)。结论早产儿胃肠功能障碍的发生率较高,尤其是极低出生体质量及胎龄≤32周的早产儿,且与窒息、感染等因素有关。血LAC参数的变化可作为早产儿发生胃肠功能障碍的警示参数及诊断参考指标。早产儿出现胃肠功能障碍病死率明显增加,应重视对其早期干预。

Objective To investigate Ihe incidence,risk factors anti prognosis of the gastrointestinal dysfunction in the premature in- fants. Methods The relationship between different gestational ages or birth weights and gastrointestinal dysfunction were analyzed in the 206 eases of premature infants. The incidence of gastrointestinal dysfunction were compared in the pr^matare infants c：ombined with asphyxia and inhx：tion. The level of lactic acid （LAC） was measured oR premature infants in gastrointestinal dysfunctinn group and non - gastrointestinal dysfunction group. The mortality in the 2 groups were calculated. Results The incidence of the gastrointestinal dystunction was 21.36% （44/ 206 cases） in premature infants. The incidence of gastrnintestinal dysfunction between the low birth weight intants and very low birth weight infants was significantly different（x^2 = 13. 598 ,P = 0. 000 2）. And the incidence was significantly different between the premature infants of gestational age≤32 weeks and gestational age 〉 32 weeks（x^2 = 6.90,：1, P = O. 009 0）. The incidence of gastrointestinal dysfunetion in the pre- mature infants with asphyxia or infection were higher,and the differenees were statistically significant （P 〈 0.01 ）. The level of LAC in the gastrointestinal dysfunction group was significantly higher than that in the non - gastrointestinal dysfunetion group （ t = 32. 849, P 〈 0. 001 ）. There were significant diffrenees of the mortality between 2 groups（x^2 = 6. 032,P=0. 014 0）. Conclusions There is a higher incidence of gastrointestinal dystunction in the premature infants,cspecially in the very low birth weight infants and premature inlants of gestational age≤32 weeks. And the incidence is related to asphyxia and infectiun. The level of I,AC can he used as an alert parameter and diagnostic indicator of the gastrointestinal dysfunction. There is a signit]cant increase of mortalily in the premature infants with gastrointestinal dyslunction,so early diagnosis and intervention is important.