不同胎龄足月儿临床转归研究

Study on clinical outcome of term infants with different gestational age

目的探究不同胎龄足月儿临床转归。方法选取2015年1月-2017年1月在淄博市中心医院收治的231例住院足月儿为研究对象,依据出生胎龄,将胎儿分为145例完全足月儿组(出生胎龄39~40周)和86例早期足月儿组(出生胎龄37~38周)。对两组胎儿非呼吸系统各项指标、各类疾病发生情况、并发症及预后情况进行比较。结果两组的低血糖发生率和静脉使用抗生素率比较,差异有统计学意义(P<0.05);两组的住院天数比较,差异有统计学意义(P<0.05)。两组的低血糖发生率、静脉使用抗生素率及住院天数比较,早期足月儿组高于完全足月儿组;两组的低体温、低血糖、湿肺、感染、呼吸窘迫综合征及高胆红素血症发生率比较,差异有统计学意义(P<0.05),且早期足月儿组高于完全足月儿组;两组的缺氧缺血性脑病、颅内出血、持续肺动脉高压、动脉导管未闭、气漏、脑室周围白质软化症(PVL)发生率比较,差异有统计学意义(P<0.05),早期足月儿组高于完全足月儿组;两组的治愈率和死亡率比较,差异无统计学意义(P>0.05)。结论早期足月儿发育仍未成熟,各类疾病和并发症的发生率较高,虽经治疗后近期预后无影响,但临床中仍需降低孕37~38周分娩的发生率。

Objective To explore the clinical outcome of term infants with different gestational ages. Methods A total of 231 term infants were enrolled in our hospital from January 2015 to January 2017. The fetuses were divided into 145 full term infants （39-40 weeks gestational age） and 86 early term infants （37-38 weeks of gestation）. Comparison of the two groups of fetal non-respiratory system indicators, the incidence of various diseases, complications and prognosis were made. Results The incidence of hypoglycemia and intravenous antibiotic use in early term infants and complete term infants were statistically signifcant （P 〈 0.05）. The early term infants and complete term children were hospitalized with χ2 test and there were statistically signifcant （P 〈 0.05）. The incidence of hypoglycemia in early term infants, the rate of intravenous use of antibiotics, and the number of hospital days were higher than those of full term children, which was statistically signifcant （P 〈 0.05）. The incidence of hypothermia, hypoglycemia, wet lung, infection, respiratory distress syndrome and hyperbilirubinemia in early term infants and complete term children was signifcantly different （P 〈 0.05）. The incidence of hypothermia, hypoglycemia, wet lung, infection, respiratory distress syndrome and hyperbilirubinemia in early term infants was higher than that in complete term infants. There was signifcant difference between the early term infants group and the whole term children group （P 〈 0.05）. There was signifcant difference between the two groups （P 〈 0.05）. The incidence of hypoxic-ischemic encephalopathy, intracranial hemorrhage, continuous pulmonary hypertension, patent ductus arteriosus, P 〈 0.05）. The incidence of hypoxic ischemic encephalopathy, intracranial hemorrhage, continuous pulmonary hypertension, patent ductus arteriosus, air leakage and PVL in early term infants were higher than those in full term infants. There was no signifcant difference in the cure rate and mortality between early term infants and complete term children （P 〉 0.05）. Conclusion The development of early term infants is still not mature, and the incidence of various diseases and complications is high. Although there is no signifcant effect on the short-term prognosis after treatment, there is still a need to reduce the incidence of pregnancy from 37 weeks to 38 weeks.