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目的分析我院五年内收治超低出生体重儿(ELBWI)的并发症、死亡原因及相关围产期高危因素。方法采用回顾性分析的方法,对2008年1月至2012年12月我院出生的ELBWI的临床资料进行分析。结果五年期间我院共分娩36 991名活产新生儿,出生ELBWI 47例,出生率0.13%;其中4例出生后即转院治疗,故43例纳入研究,胎龄(27.8±2.6)周,出生体重(853±108)g。43例ELBWI中,早期存活并进行救治27例,其中并发新生儿呼吸窘迫综合征20例,发生率74.1%(20/27);并发支气管肺发育不良7例,发生率25.9%(7/27)。43例ELBWI中存活至出院13例,总存活率30.2%(13/43);30例死亡,其中21例放弃治疗死亡,9例死亡原因分别为呼吸窘迫综合征、重症感染各3例,坏死性小肠结肠炎2例,肺出血1例。死亡婴儿生后1 min Apgar评分及5 min Apgar评分均低于存活者(P<0.05)。结论医患同盟积极救治ELBWI,减少出生窒息,积极处理各种并发症,可提高ELBWI存活率及生存质量。
Objective To analyze the complications of ELBWI admitted to our hospital within five years, the causes of death and the related risk factors of perinatal period. Methods The clinical data of ELBWI born in our hospital from January 2008 to December 2012 were analyzed retrospectively. Results During the five-year period, 36,991 live-born newborns were born in our hospital and 47 were born with ELBWI, with a birth rate of 0.13%. Among them, 4 were transferred to hospital after birth and 43 were included in the study. The gestational age (27.8 ± 2.6) weeks was born Weight (853 ± 108) g. In 43 cases of ELBWI, 27 cases survived early and were treated, including 20 cases of neonatal respiratory distress syndrome (74.1%, 20/27) and 7 cases of bronchopulmonary dysplasia (25.9%, 7/27 ). Thirty-three patients survived and were discharged to hospital in 13 of 43 ELBWI patients, with a total survival rate of 30.2% (13/43). Thirty patients died, of whom 21 gave up their treatment and 9 died of respiratory distress syndrome. Severe infections were 3 and necrotic 2 cases of enterocolitis, 1 case of pulmonary hemorrhage. Apgar score and Apgar score at 5 min after birth in infants died less than those in survivors (P <0.05). Conclusion The medical and patient alliance actively treated ELBWI, reduced birth asphyxia and actively treated various complications, which could improve the survival rate and quality of life of ELBWI.