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目的:分析超低出生体质量早产儿(ELBWI)相关的病因、并发症,以便更好地制定诊疗方案,改善患儿临床结局。方法:采用回顾性研究方法,选取我院NICU 1998年5月至2004年12月收治的ELBWI 32例(A组)和2012年1月至2014年6月收治的ELBWI 79例(B组),对相关早产原因、并发症进行比较分析。结果:B组中母亲行体外受精胚胎移植术(IVF-ET)、不良孕育史的患儿比例高于A组(P<0.05)。B组酸中毒、早产儿视网膜病变(ROP)、动脉导管未闭(PDA)、低血糖、休克、低体温、硬肿症的发生率较A组下降,新生儿呼吸窘迫综合征(NRDS)、支气管肺发育不良(BPD)的发生率较A组升高(P均<0.05)。B组中,胎龄<28周的患儿NRDS、脑室周围白质软化(PVL)、呼吸暂停、BPD、院内感染、酸中毒、新生儿坏死性小肠结肠炎(NEC)的发生率高于胎龄≥28周的患儿(P均<0.05)。结论:ELBWI相关的早产原因和并发症较多,近年来的主要并发症为NRDS、呼吸暂停、BPD等。积极避免早产高危因素,制定正确的诊疗方案,防止严重并发症的发生,是改善ELBWI临床结局的关键。
Objective: To analyze the etiology and complications related to ELBWI in order to make a better diagnosis and treatment plan and improve the clinical outcomes in children. Methods: A retrospective study was conducted to select 32 ELBWI patients in our hospital from May 1998 to December 2004 (group A) and 79 ELBWI patients (group B) from January 2012 to June 2014, The causes of preterm birth, complications were compared. Results: In group B, the proportion of mothers who underwent IVF-ET and poor pregnancy history was significantly higher than that of group A (P <0.05). The incidence of acidosis, retinopathy of prematurity (ROP), patent ductus arteriosus (PDA), hypoglycemia, shock, hypothermia and scleredema in group B were lower than those in group A, neonatal respiratory distress syndrome (NRDS) The incidence of bronchopulmonary dysplasia (BPD) was higher than that of group A (all P <0.05). In group B, the incidence of NRDS, periventricular leukomalacia (PVL), apnea, BPD, nosocomial infections, acidosis, and neonatal necrotizing enterocolitis (NEC) were significantly higher in gestational age <28 weeks than gestational age Children ≥28 weeks (all P <0.05). Conclusion: There are many causes and complications of ELBWI related to preterm birth. The main complications in recent years are NRDS, apnea, BPD and so on. Actively avoid the risk factors of preterm birth, to develop the correct diagnosis and treatment programs to prevent the occurrence of serious complications, is to improve the clinical outcome of ELBWI key.