围生期新生儿疾病的影响因素及死亡原因探讨(附2250例分析)

STUDY ON THE INFLUENCE FACTORS OF THE DISEASES AND THE DEATH CAUSES IN PERINATAL PERIOD NEWBORNS:ANALYSIS OF 2250 CASES

目的 :研究围生期新生儿发病情况、死亡原因及围生期新生儿疾病的有关影响因素。方法 :总结我院儿科 1 5年住院围生期新生患儿 2 2 5 0例 ,根据年限分为三组 ,分析各组的发病和死亡情况。结果 :本组病人占同期住院新生儿的 4 3.6%。死亡 30 2例 ,占儿科死亡病例的 4 1 .5 % ,平均死亡率 1 3.33% ,近年有逐渐下降趋势 (χ2 =37.0 71 3,P<0 .0 1 )。死因有早产、颅内出血、硬肿症、严重感染等。产前产时缺氧、妊高症是主要疾病原因 ,与正常妊娠分娩有显著性差异 (χ2 =1 76.4 95 6,P<0 .0 1 )。近年感染性疾病明显减少 ( P<0 .0 1 ) ,生后营养护理因素和先天发育缺陷疾病也有所减少 ( P<0 .0 5和 P>0 .0 5 ) ,妊娠分娩黄疸增多 ( P<0 .0 1 )。结论 :早产是影响围生期新生儿疾病和死亡的重要原因 ,早产常合并硬肿症、颅内出血、缺血缺氧性脑病( HIE)、严重感染。因此加强孕期保健、防止妊高症及早产 ,提高救治高危产妇和新生儿的水平是降低围生期新生儿病死率的有效措施。

Objective:To study the condition of suffering from diseases,death causes and the related influence factors in perinatal period newborns.Methods:We summmed up 2250 hospitalized perinatal newborns over a period of 15 years.According to the times,the newborn patients were divided into three groups.The condition of disease and death in each group were analysed.Results:The newborn patients accounted for 43 5% of the hospitalized newborns in the same period.302 newborn patients were died,representing 41.5% of pediatric death patients.The average death rate was 13 33% and gradually declined in recent years(χ 2=37 0713, P <0 01).The main causes of deaths were premature delivery,intracranial hemorrhage,scleredema,serious infection and so on.The hypoxia in antepartum and intrapartum and pregnancy induced hypertension syndrome(PIH) were the main causes of diseases,which had significant difference compared with normal pregnancy and delivery( χ 2 =176 4956, P <0 01).Infectious diseases were obviously decreased in recent years( P <0 01).The diseases caused by nutrition of nurse factors after the birth and congenital dysplasia were decreased,too( P<0 05 and P>0 05 ).The jaundice due to pregnancy and parturition and various kinds of factors were increased( P <0 01)。Conclusion:Premature is important cause that affects the perinatal newborn diseases and death.Premature is frequently complicated by scleredema,intracranial hemorrhage,hypoxic ischemic encephalopathy(HIE) and serious infection.Therefore,to strengthen pregnancy health care,prevent PIH and premature delivery,improve the levels in treating and curing high risk pregnant women and newborns is an effective measure that reduces morbidity an mortality rates in perinatal newborns.