49例多胞胎极低出生体重儿的临床管理

Clinical management for 49 cases of very-low-birth-weight neonates resulted from multifetal pregnancies

目的 探讨多胞胎极低体重儿的并发症及干预措施。方法 回顾性分析 1998年 1月至2 0 0 2年 1月本院新生儿重症监护病房 (NICU)收治的多胞胎极低体重儿的结局。结果 多胞胎极低体重儿的并发症多 ,60 %的极低体重儿合并 3种以上的并发症 ,病死率高达 2 4.5 %。结论 多胞胎极低体重儿易发生许多临床问题 ,从整个产程的监测到分娩时的处理 ,新生儿窒息的复苏到出生后的监护治疗、液体管理和热卡的供给 ,以及严格的消毒隔离制度 ,是一个系统的管理过程 ,必须重视每一个环节 ,才能使患儿安全度过危险期。

Objective To investigate the complications and clinical interventions for very-low-birth-weight neonates resulted from multifetal-pregnancies.Methods The outcomes of 65 very-low-birth-weight infants hospitalized in NICU of Health Institute for Women and Children of Yinchuan City from January 1998 to January 2002 were retrospectively analyzed.Results There were over three kinds of complications in 60% of very-low-birth-weight neonates,and the mortality rate was as high as to 24.5 %.Conclusion The most very-low-birth-weight neonates resulted from multinetal pregnancies suffers from many medical problems.Therefore every step in the process is critical for getting better outcomes.The process includes close monitoring in the prenatal period and during childbirth,appropriate resuscitation after birth,postpartum monitoring and management including supply of fluids and nutrients and a safe and clean environment.These factors will play an important role in helping very-low-birth-weight neonates to pull through the critical periods.