极低出生体重儿住院期间生长速度及相关影响因素分析

Study on body growth rate in hospitalization and its correlative influencing factors of very low birth weight infants

目的探寻影响极低出生体重儿住院期间的生长速度及其相关影响因素,为以后临床工作中对极低出生体重儿治疗护理提供帮助。方法对南通市妇幼保健院NICU住院的极低出生体重儿定期测量体重、身长、头围,绘成生长曲线图。分析体重、身长、头围的生长,及其影响因素。结果体重宫内生长迟缓(IUGR)17例(16.19%),宫外生长迟缓(EUGR)41例(39.05%);身长IUGR22例(20.95%);EUGR35例(33.33%);头围IUGR9例(8.57%),EUGR15例(15.24%)。体重EUGR组与非EUGR组:孕母胎膜早破、宫腔感染发生率EUGR组明显高于非EUGR组,两组差异有统计学意义(P<0.05);EUGR组住院期间合并慢性肺病、败血症、动脉导管未闭发生率明显高于非EUGR组,两组差异有统计学意义(P<0.05);EUGR组CPAP通气时间、气管插管辅助通气使用率及时间明显高于非EUGR组,两组差异有统计学意义(P<0.05)。结论极低出生体重儿的管理,需重视生长曲线图的描绘,关注生长曲线显示为下跌趋势患儿,及时查找原因,及时干预,对孕母胎膜早破、宫腔感染的监测与预防,住院期间积极治疗慢性肺病、败血症、动脉导管未闭等并发症,是防止极低出生体重儿发生EUGR的关键。

Objective To study body growth rate in hospitalization and its correlative influencing factors of very low birth weight infants（VLBWI）,and provide help for the treatment of VLBWI in the future clinical work. Methods A total of 105 VLBWI in NICU were selected.Their weight,length and head circumference were measured regularly for growth curve chat.The growth rate of weight,length and head circumference and its correlative influencing factors were analyzed.Results The weight of intrauterine growth retardation（IUGR）17cases（16.19%）,and extrauterine growth retardation（EUGR）41cases（39.05%）,the length of IUGR 22cases（20.95%）,EUGR 35cases（33.33%）,the head circumference of IUGR 9cases（8.57%）,and EUGR 15cases（15.24%）.The weight of EUGR group and non EUGR group：rates of maternal premature rupture of membranes,intrauterine infection in EUGR group were significantly higher than those in non EUGR group,there were significant differences between two groups（P〈0.05）;The incidence rates of chronic lung disease,sepsis,patent ductus arteriosus（PDA）in EUGR group during hospitalization were significantly higher than those in non EUGR group,there were significant differences between the two groups（P〈0.05）;CPAP ventilation time rate and time of tracheal intubation and assisted ventilation in EUGR group were significantly higher than those in non EUGR group,there were significant differences between the two groups（P〈0.05）. Conclusions The VLBWI management need to pay attention to depict the growth curve,which shows the downward trend of children and find out the reasons in time for timely intervention.The monitoring and prevention of premature rupture of membranes,intrauterine infection,and active treatment chronic lung disease,sepsis,PDA and other complications during hospitalization,is the key to prevent the very low birth weight infants＇ EUGR.