62例双胎小早产儿的临床分析

Clinical analysis of 62 case of twin very premature infants

目的分析双胎小早产儿的临床特点。方法回顾性分析2010年1月-2014年12月在淮安市妇幼保健院新生儿医学中心收治的胎龄〈32周、住院时间≥2周且痊愈的早产儿的临床资料。将入选的双胎早产儿纳入观察组（n=62）,按1∶1的比例随机选取入选的单胎早产儿为对照组（n=62）。根据分娩顺序将观察组分为大双组（n=30）和小双组（n=32）。根据每对双胎中出生体重的高低,分为轻胎组（n=20）和重胎组（n=20）。分析各组早产儿的临床资料进行。结果观察组采用辅助生殖技术受孕的小早产儿比率高于对照组,差异有统计学意义（χ^2=4.379,P=0.036）。观察组小早产儿新生儿窒息（χ^2=4.052,P=0.044）、喂养不耐受（χ^2=4.826,P=0.028）和宫外发育迟缓（χ^2=3.929,P=0.048）的发生率均高于对照组。小双组小早产儿在新生儿窒息（χ^2=6.087,P=0.013）和呼吸窘迫综合征（χ^2=3.996,P=0.046）的发生率高于大双组。轻胎组小早产儿在喂养不耐受（χ-2=6.667,P=0.010）和宫外发育迟缓（χ-2=6.465,P=0.011）发生率高于重胎组。结论双胎小早产儿易发生新生儿窒息、喂养不耐受和宫外发育迟缓;后出生的小早产儿易发生新生儿窒息和呼吸窘迫综合征;出生体重轻的小早产儿易发生喂养不耐受和宫外发育迟缓。

Objective To investigate the clinical characteristics of the twin very premature infants（VPI）. Methods Clinical data of preterm infants who admitted to Neonatal Medical Center of Huai＇an Maternity and Child Healthcare Hospital from January 2010 to December 2014 were retrospectively analyzed, all the preterm infants gestational age 32weeks, more than two weeks of hospital stay and survived when discharged of the data. The twin preterm children were enrolled into the observation group（n = 62）, the singleton preterm infants were randomly selected as control group（n =62） in proportion to 1︰1. The observation group was divided into big twin group（n = 30） and small twin group（n =32） according to the birth order. The observation group was divided into light twin group（n = 20） and heavy twin group（n = 20） according to the birth weight. The data of preterm infants in each group was analyzed. Results Percentage of VPI conceived through assisted reproductive technology in the observation group was higher than that in the control group（χ^2= 4.379, P = 0.036）. Incidence of neonatal asphyxia（χ^2= 4.052, P = 0.044）, feeding intolerance（χ^2= 4.826,P = 0.028） and extra uterine growth restriction（EUGR）（χ^2= 3.929, P = 0.048） of VPI in the observation group were higher than that of the control group. Incidence of neonatal asphyxia（χ^2= 6.087, P = 0.013） and respiratory distress syndrome（χ^2= 3.996, P = 0.046） of twin VPI in the small twin group were higher than that of the big twin group. Incidence of feeding intolerance（χ^2= 6.667, P = 0.010） and EUGR（χ^2= 6.465, P = 0.011） of VPI in light twin group was higher than that of the heavy twin group. Conclusion Twin VPI prone to neonatal asphyxia, feeding intolerance and EUGR. TPI of second birth twin prone to neonatal asphyxia and respiratory distress syndrome. TPI of low birth weight twin prone to feeding intolerance and EUGR.