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目的探讨极低体重儿围生期死亡和生长缓慢的原因。方法回顾性分析296例极低体重儿的临床资料、患儿围生期死亡情况以及可能导致患儿死亡的主要原因和患儿宫外生长情况及可能的生长发育迟缓的原因。结果 296例极低体重儿围生期死亡91例,占30.74%;单因素方差分析显示产妇合并妊娠期高血压疾病、脐带绕颈、胎龄低、胎重小及出生后颅内出血、感染是导致极低体重儿死亡的主要原因,Logistic分析显示产妇合并妊娠期高血压疾病、脐带绕颈和颅内感染是极低体重儿死亡的独立危险因素。患儿成功出院205例,其中94例生长发育迟缓,占45.86%;单因素方差分析显示母亲妊娠期高血压疾病、呼吸暂停、坏死性小肠结肠炎和静脉营养支持是导致极低体重儿出院后生长缓慢的主要原因,Logistic分析显示母亲妊娠期高血压疾病是导致极低体重儿出院后生长缓慢的独立危险因素。结论对于极低体重新生儿,产妇合并妊娠期高血压疾病、脐带绕颈和颅内感染是导致死亡的独立危险因素,母亲妊娠期高血压疾病是导致宫外生长发育迟缓的独立危险因素。应根据具体情况加以重视和护理,则有可能降低极低体重儿死亡和生长缓慢。
Objective To investigate the causes of perinatal death and slow growth in very low birth weight infants. Methods Retrospective analysis of 296 cases of very low birth weight infants clinical data, the perinatal death of children and the possible causes of death in children and the causes of extrauterine growth and possible growth retardation in children. Results A total of 296 cases of very low birth weight infants died during the perinatal period, accounting for 30.74%. Univariate analysis of variance showed that maternal complicated with gestational hypertension, umbilical cord around the neck, low gestational age, small fetal weight and intracranial hemorrhage after birth were Logistic analysis showed that maternal morbidity of hypertensive disorder complicating pregnancy, cord around the neck and intracranial infection were independent risk factors for the death of very low birth weight infants. 205 children were successfully discharged, of which 94 cases of growth retardation, accounting for 45.86%; univariate analysis of variance showed that maternal hypertensive disorders during pregnancy, apnea, necrotizing enterocolitis and intravenous nutritional support is caused by very low birth weight children discharged Logistic analysis showed that maternal hypertensive disorder during pregnancy was an independent risk factor for the slow growth of very low birth weight children after discharge. Conclusions For very low birth weight infants with maternal complications of gestational hypertension, umbilical cord around the neck and intracranial infection are independent risk factors of death. Hypertensive disorder complicating pregnancy is an independent risk factor for extrauterine growth retardation. Should be based on the specific circumstances of attention and care, it is possible to reduce the death of very low birth weight children and slow growth.