极低出生体重儿116例临床分析

The Accessing Care of The Early Health Interference and The Growth of Infant Times on Premature Very Low-Birth-Weight-Infant

目的 探讨影响极低出生体重儿 (verylowbirthweightinfant,VLBWI)存活率的相关因素 ,为降低其病死率和病残率提供依据。 方法 对 1993年 1月～ 1998年 1月收治的 116例VLBWI按体重分三组 ,对其临床资料进行回顾性分析。 结果 VLBWI治愈出院 86例 ,治愈率74 .1% (86 116 ) ;随体重增加而上升 (P <0 .0 5 ) ;治愈者平均住院 (2 7± 13)d ,住院天数随体重增加而缩短 (P <0 .0 5 ) ;病死 15例 ,病死率 12 .9% (15 116 ) ;病死率随体重增加而降低 (P <0 .0 1)。导致VLBWI的主要原因有多胎妊娠 (2 6 .7% ) ,胎膜早破 (2 1.4 % ) ,妊娠并发症 (12 .6 % ) ,习惯性早产(3.1% ) ,妊娠期患内科慢性疾病 (1.3% )和原因不明 (34.9% )。所有住院患儿均有一种以上并发症 ,≤ 10 0 0 g的超低出生体重儿的发生率高达83.3% ,其体重越低 ,并发症的发生率越高 (P <0 .0 1)。存活率 87.1% ,体重≤ 10 0 0 g存活率为 5 6 .3%。死亡的主要原因是肺出血、呼吸窘迫综合征、感染和颅内出血。 结论 提高VLBWI近远期存活率 ,除重视围产期及儿科的处理外 ,VLBWI必须早期发现 ,密切监护 ,及时处理并发症。

Objective To investigate the relationship factor of livability on Premature Very Low-Birth-Weight-Infant (PVLBWL), for refer to evidences that reduce the mortality and the deformity rate. Methods The group 116 PVLBWL cases, being in our hospital hear five years, divide into three team according to the weight, and analyze the review clinical data of the cases (from 1993.1 to 1998.1). Results There are 86 cases that had cured and left hospital in the group. The cure rate is 74.1%(86/116). It is rise along with the weight increase (P<0.05). It is (27±13) days that the cure being in hospital. It is shortened along with the weight increase (P<0.05). It is 15 infants in the group dead, mortality 12.9%(15/116). It is reduced along with increasing. The mostly effect reasons are excessive-embryo-pregnancy(26.7%)、amnion-early-break(21.4%)、combine-symptom in pregnancy(12.6%)、practice-premature(3.1%)、chronic illness in gestation(1.28%) and unclear reason (34.9%). The infants been in hospital all have more than one combine symptom. It is 83.3% in the group which weight ≤1 000 g. The weight more lower, the combine symptom more many (P< 0.01). The livability is 87.1% in the group; the livability is 56.3% in which weight ≤1 000 g. The mostly effect reasons of death are bleeding in lung、breath-embarrassment、synthesis 、infection and bleeding in encephalic. Conclusion To improve the near and far livability and reduce the mortality and the deformity rate of the VLBWI, except recognition manage of confinement and pediatrics, we must early discover VLBWI, and supervising care strictly, managing the combine symptom in time.