重症监护病房新生儿死亡病例分析

Analysis of neonatal death in neonatal intensive care unit

目的探讨新生儿重症监护病房(NICU)新生儿死亡的危险因素及变迁。方法回顾性分析我院NICU 2004年1月—2009年12月期间死亡的129例患儿的病历资料,筛选死亡危险因素。结果体重<1.5 kg新生儿年均病死率9.2%;胎龄≤32周早产儿年均病死率为9.4%;死亡新生儿中出生48 h内病死率达34.9%.2004年—2009年新生儿直接死亡原因排序依次为感染性疾病、窒息及其并发症、先天性畸形、其他疾病。结论胎龄小、出生体重低及母亲高龄始终是新生儿死亡的高危因素,死亡高危时段在出生后48 h内。感染性疾病、窒息及其并发症是最主要的直接死因,先天性畸形致死率增高,疾病谱有扩大趋势。

Objective To explore the risk factors and change of neonatal death in neonatal intensive care unit（NICU）.Methods Retrospectively analyzed the data of 129 cases of death children in our NICU during January 2004 and December 2009 and study the risk factors for death.Results The average annual mortality rate in newborn with birth-weight 1.5 kg was 9.2%.The average annual mortality rate in preterm children with gestational age ≤32 weeks reached 9.4%.34.9% of the total death newborn died within 48 h.During the 6 years,the sort order of the direct cause of neonatal death was infectious diseases,asphyxia and its complications,congenital malformations and other diseases.Conclusion Small gestational age,low birth-weight and older pregnant women are always the risk factors for neonatal death.48h after birth is the death high-risk period.Infectious diseases,asphyxia and its complications are the most important direct causes of death.The death rate of congenital malformations increases.Disease spectrum has expanded trend.