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[目的]探讨极低出生体重儿(VLBWI)出生的危险因素及影响其存活率的因素,为降低其死亡率提供帮助。[方法]122例VLBWI按出生体重分为3组,即≤1000g,1001～1250g和1251～1500g,并对其临床资料进行回顾性分析。[结果]治愈69例,治愈率56.56%,治愈率随体重增加而上升(P=0.018);死亡13例,病死率10.66%,死亡率随体重增加而降低(P=0.000)。导致VLBWI的主要原因有妊娠高血压综合征(30人,24.59%),胎膜早破(28,22,95%),多胎妊娠(24人,19.67%),前置胎盘/胎盘早剥(12例,9.83%),妊娠期母患内科疾病(10人,8.19%)。,胎儿宫内窘迫(6人,4.92%),原因不明(12人,9.83%)。住院的VLBWI均有1种或1种以上并发症,主要有代谢性酸中毒(94例,77.05%),高胆红素血症(74例,60.65%),新生儿暂时性凝血功能异常(72例,59.02%),新生儿贫血(68例,55.74%),新生儿心肌损伤(52例,42.62%),新生儿肺透明膜病(40例,32.79%),肺炎(26例,21.31%),早产儿视网膜病变(18例,14.75%),颅内出血(12例,9.83%),肺出血(4例,3.27%)。死亡的主要原因为急性呼吸窘迫综合征(RDS),肺出血,感染和脑室内出血。[结论]加强对VLBWI围生期高危因素的认识,积极预防早产,采取综合治疗措施,减少并发症的发生,可降低其病死率,提高VLBWI的生存质量。
[Objective] To explore the risk factors for the birth of very low birth weight (VLBWI) and the factors influencing their survival, and to help reduce their mortality. [Method] 122 cases of VLBWI were divided into 3 groups by birth weight, that is, ≤1000g, 1001 ~ 1250g and 1251 ~ 1500g, and their clinical data were retrospectively analyzed. [Result] 69 cases were cured, the cure rate was 56.56%. The cure rate increased with body weight gain (P = 0.018). Thirteen cases died and the case fatality rate was 10.66%. The mortality rate decreased with weight gain (P = 0.000). The main causes of VLBWI were gestational hypertension (30 cases, 24.59%), premature rupture of membranes (28,22,95%), multiple pregnancy (24 cases, 19.67%), placenta previa 12 cases, 9.83%), mother’s disease during pregnancy (10, 8.19%). , Fetal distress (6, 4.92%), unknown cause (12, 9.83%). In-hospital VLBWI has one or more complications, mainly metabolic acidosis (94 cases, 77.05%), hyperbilirubinemia (74 cases, 60.65%), neonatal transient coagulation disorders 72 cases, 59.02%), neonatal anemia (68 cases, 55.74%), neonatal myocardial injury (52 cases, 42.62%), neonatal hyaline membrane disease (40 cases, 32.79%), pneumonia %), Retinopathy of prematurity (18 cases, 14.75%), intracranial hemorrhage (12 cases, 9.83%) and pulmonary hemorrhage (4 cases, 3.27%). The main causes of death are acute respiratory distress syndrome (RDS), pulmonary hemorrhage, infection and intraventricular hemorrhage. [Conclusion] To strengthen the understanding of perinatal high risk factors of VLBWI, to prevent premature delivery actively, to take comprehensive treatment measures to reduce the incidence of complications, reduce its mortality and improve the quality of life of VLBWI.