367例早产儿临床资料分析

Clinical analysis of 367 cases of premature infants

目的分析某Ⅱ级新生儿病房收治的早产儿特点及其住院期间并发症情况,为临床诊治提供参考。方法回顾性分析2014年1月1日至2015年12月31日上海市长宁区妇幼保健院收治的全部早产儿临床资料,采用描述性方法分析围产期因素及并发症发病情况及转归。结果Ⅱ级病房住院早产儿以晚期早产儿为主,占79.02%,平均胎龄34.85±1.28周,平均体重2 273.07±362.581g;胎膜早破是最主要的早产原因,占47.68%;49.05%的母亲患孕期合并症,其中妊娠期糖尿病发生率最高,为87例,发生率为23.71%;84.20%的早产儿在住院期间出现并发症,其中高胆红素血症的发生率最高,为54.77%,其次为湿肺,发生率为21.53%,接下来依次是低血糖、喂养不耐受、贫血和酸中毒等。方差分析显示,胎龄越小住院时间越长,差异有统计学意义(F=17.314,P<0.001)。有并发症者住院时间更长,与无并发症者相比差异有统计学意义(t=3.237,P=0.002)。对住院时间的影响因素进行多元线性回归分析,结果显示影响程度最大的是喂养不耐受,喂养不耐受早产儿平均补液时间远大于其他早产儿,分别为14.4±6.36天和7.36±3.20天,导致平均住院时间达15.08±6.50天,而其他早产儿平均住院时间仅9.67±5.05天,差异有统计学意义(t=6.837,P<0.001)。结论Ⅱ级新生儿病房收治患儿以晚期早产儿为主,住院期间并发症发生率较高,要加强观察,及时干预,缩短住院时间。

Objective To analyze the characteristics of premature infants admitted to a class II neonatal ward and their complications during hospitalization, so as to provide reference for clinical diagnosis and treatment. Methods Clinical data of all premature infants admitted in Shanghai Changning Maternal and Child Health Care Hospital from Januaryl, 2014 to December 31, 2015 were retrospectively analyzed, and perinatal factors and morbidity and prognosis of complications were analyzed with descriptive methods. Results Preterm infants hospitalized in the class Ⅱ ward were mainly late preterm infants accounting for 79.02%, with mean gestational age of 34.85 ± 1.28 weeks and mean weight of 2 273.07± 362.581g. Premature rupture of membranes was the main reason for preterm birth, accounting for 47. 68% in all premature infants. Totally 49. 05% of mothers had pregnancy complications and incidence of gestational diabetes was highest, which was found in 87 cases, accounting for 23.71%. During hospitalization, 84.20% of premature infants developed complications, in which the incidence of hyperbilirubinemia was highest, accounting for 54.77%, followed by wet lung which incidence was 21.53%, hypoglycemia, feeding intolerance, anemia and acidosis in turn. Variance analysis showed that longer hospital stay was found among those with smaller gestational age with significant difference （F=17.314, P〈0.001）. Preterm infants with complications had longer hospital stay than those without complications, and difference had statistical significance （t = 3.237, P = 0.002）. Multiple linear regression analysis on influencing factors of hospitalization time indicated that feeding intolerance had biggest influence on hospital stay. Rehydration treatment time in preterm infants with feeding intolerance （14.4±6.36d） was significantly longer than that in other preterm infants （7.36±3.20d）. This caused mean hospital stay of feeding intolerance preterrn infants to reach 15.08±6.50 days, while mean hospital stay of other preterm infants was only 9.67±5.05 days with significant difference （t=6.837,P〈0.001）. Conclusion Preterm infants admitted in class II neonatal ward are mainly late preterm infants. Incidence of complications during hospitalization is high. Observation should be strengthened and intervention in time to shorten hospitalization.