97例超早产儿的临床结局分析

Analysis of clinical outcomes of 97 cases of extremely preterm infants

目的 分析97例超早产儿(EPI)的临床结局。方法 选取2019年1月至2022年12月南通大学附属妇幼保健院新生儿重症监护室收治的97例EPI,分析并发症发生情况及临床结局。结果 EPI相关并发症发生率较高的为新生儿呼吸窘迫综合征、新生儿肺炎、支气管肺发育不良(BPD)、脑室内出血(IVH)及早产儿视网膜病变(ROP)。97例EPI中,存活56例,存活率为57.73%;抢救无效宣布死亡及放弃治疗院内死亡41例,死亡率为42.27%。胎龄26~27+6周EPI存活率高于胎龄<26周EPI,体重≥1 kg EPI存活率高于体重<1kgEPI(P<0.05)。存活组BPD、ROP和动脉导管未闭发生率高于死亡组,肺出血及Ⅲ、Ⅳ级IVH发生率低于死亡组(P <0.05)。结论 EPI救治水平虽不断提升,但存活率仍较低、并发症发生率较高,EPI救治需加强多学科合作、围生期管理、EPI综合管理,共同促进EPI早期健康发展,降低病死率,改善生存质量。

Objective To analyze the clinical outcomes of 97 cases of extremely preterm infants(EPI).Methods A total of 97 EPI admitted to the Neonatal Intensive Care Unit of Affiliated Maternity and Child Health Hospital of Nantong University from January 2019 to December 2022 were selected.The complications and clinical outcomes were analyzed.Results The high incidence of EPI-related complications were neonatal respiratory distress syndrome,neonatal pneumonia,broncho-pulmonary dysplasia(BPD),intraventricular hemorrhage(IVH)and retinopathy of prematurity(ROP).Among 97 cases of EPI,56 cases(57.73%)survived.Forty-one cases were declared dead after rescue failure or abandoned treatment in hospital,the mortality rate was 42.27%.The survival rate of EPI at gestational age of 26-27+6 weeks was higher than that at gestational age<26 weeks,and the survival rate of EPI at weight≥1 kg was higher than that at weight<1 kg EPI(P<0.05).The incidence of BPD,ROP and patent ductus arteriosus in survival group was higher than that in death group,and the incidence of pulmonary hemorrhage and gradeⅢandⅣIVH in survival group was lower than that in death group(P<0.05).Conclusion Although the treatment level of EPI has been continuously improved,the survival rate is still low and the complication rate is high.The treatment of EPI needs to strengthen multidisciplinary cooperation,perinatal management and comprehensive EPI management,so as to jointly promote the early healthy development of EPI,reduce the fatality rate and improve the quality of life.