952例住院早产儿临床特征及预后高危因素分析

Analysis on clinical characteristics and high-risk factors of prognosis in 952 hospitalized premature infants

目的探讨住院早产儿的临床特征及影响预后的高危因素。方法选择2013-2015年在宁夏某三级甲等医院住院早产儿的临床资料,对住院早产儿的基本资料、并发症及临床结局等指标进行统计描述分析。结果 2013-2015年在新生儿重症监护室(NICU)住院的早产儿952例,平均胎龄(32.45±6.39)周,平均出生体质量(1.92±0.59)kg,住院中位天数为29.64 d,早产儿并发症所占比例前3位依次为高胆红素血症306例(32.14%)、新生儿肺炎232例(24.37%)和新生儿呼吸窘迫综合征187例(19.64%)。治愈或好转出院752例(78.99%);经治疗无效而死亡或自动出院(转院或放弃治疗)200例(21.01%)。2013-2015年住院早产儿中早期早产儿所占比例逐年增加(P<0.05),住院早产儿出生体质量逐年增加(P<0.05),高胆红素血症、颅内出血在住院早产儿中所占比例逐年上升,新生儿肺炎和新生儿呼吸窘迫综合征所占比例逐年下降(P<0.05),住院早产儿治愈/好转率提高,死亡率(自动出院)下降(P<0.05),住院费用逐年上升(P<0.05),早产儿胎龄、出生体质量及神经系统疾病(颅内出血、新生儿脑损伤)影响住院早产儿的临床结局(P<0.05)。结论早期早产儿的发生率逐年上升,并影响住院早产儿的临床结局。医护工作者应加强孕期保健指导,帮助孕妇养成良好的生活习惯和规律产检的习惯,降低早期早产的发生率,从而在一定程度上改善住院早产儿的临床结局,提高住院早产儿的生活质量。

Objective To explore the clinical characteristics and high-risk factors of prognosis in hospitalized premature infants.Methods The clinical data of hospitalized premature infants in a grade Ⅲ level A hospital of Ningxia Hui Autonomous Region from 2013 to 2015 were selected,then the general data,complications,and clinical outcomes were analyzed statistically. Results From 2013 to 2015,952 hospitalized premature infants were collected from NICU,the average gestational age was（ 32. 45±6. 39） weeks,the average birth weight was（ 1. 92±0. 59） kg,the median of hospitalization time was 29. 64 days. The top three complications included hyperbilirubinemia（ 306 cases,32. 14%）,neonatal pneumonia（ 232 cases,24. 37%）,and neonatal respiratory distress syndrome（ 187 cases,19. 64%）. A total of 752 premature infants（ 78. 99%） were cured or left the hospital with a better health condition,200 premature infants（ 21. 01%） died after ineffective treatment（ transfer or give up treatment）. From 2013 to 2015,the proportion of early premature infants among hospitalized premature infants increased year by year（ P0. 05）,the birth weight of hospitalized premature infants increased year by year（ P 0. 05）,the proportions of hospitalized premature infants with hyperbilirubinemia and intracranial hemorrhage increased year by year,and the proportions of hospitalized premature infants with neonatal pneumonia and neonatal respiratory distress syndrome deceresed year by year（ P0. 05）,the cure rate or improvement rate increased,the mortality rate decreased（ P 0. 05）,hospital cost increased year by year（ P 0. 05）. Fetal age,birth weight,and nervous system diseases（ intracranial hemorrhage,neonatal brain injury） affected clinical outcome of hospitalized premature infants（ P0. 05）. Conclusion The incidence rate of early premature infants increases year by year,which affects the clinical outcome of hospitalized premature infants. The health care workers should strengthen health care guidance during pregnancy,help pregnant women to develop good habits and regular prenatal examination,reduce the incidence rate of early preterm birth,so as to improve clinical outcomes and life quality of premature infants to a certain extent.