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目的:探讨2009年及2014年极低出生体重儿(VLBWI)和超低出生体重儿(ELBWI)住院情况及治疗效果的变化与进步。方法:以湖北省妇幼保健院新生儿科作为单中心进行研究,回顾性分析该院新生儿重症监护室(NICU)2014年住院的100例(A组)出生体重<1 500g患儿围产期情况、营养、呼吸支持治疗、合并症、结局等方面在内的住院信息,并与2009年在该中心住院的131例同类患儿(B组)相关信息进行比较,分析5年间2组患儿各项资料及住院结局的变化。结果:A组出生胎龄为(30.7±2.4)周;出生体重(1 278.1±142.1)g;男女比为1.94,与B组相比没有显著差异。A组双胎或多胎的比率(53%vs.44%,P<0.01)、产前激素使用率(26%vs.7.6%,P<0.01)、进入母婴同室的人数(44%vs.25%,P<0.01)及母婴同室中体重增长速度(24.1±13.4 vs.11.7±14.6,P<0.01)、肺泡表面活性物质(PS)使用率(32%vs.13.7%,P<0.01)、机械通气时间(5dvs.2d,P<0.01)、外周中心静脉置管(PICC)使用率(63%vs.13%,P<0.01)、动脉导管未闭(PDA)(36%vs.18.3%,P<0.01)、早产儿视网膜病(ROP)(13%vs.3.8%,P<0.05)及支气管肺发育不良(BPD)发生率(20%vs.5.3%,P<0.05)、住院天数(40dvs.21d,P<0.01)及住院费用(47 229元人民币vs.26 194元人民币,P<0.01)等方面均显著高于B组。A组出院体重、治愈及好转率均较B组有显著提高。结论:在过去的5年中,虽然在早产儿的治疗方法及效果上有很大提高,但在产前激素使用率、呼吸管理、营养管理、院内感染防治等方面仍存在不足,需要有针对性的改进,以期望可进一步降低并发症的发生率及死亡率。
Objective: To investigate the changes and progress of hospitalization and treatment of VLBWI and ELBWI in 2009 and 2014. Methods: Neonatology was conducted in Hubei Maternal and Child Health Hospital as a single center. The hospitalized neonatal intensive care unit (NICU) was retrospectively analyzed in 100 hospitalized patients in 2014 (Group A). The perinatal period , Nutrition, respiratory supportive care, complications, and outcomes were compared with those of 131 similar children (group B) who were hospitalized in the center in 2009. The data of two groups of children Information and changes in hospital outcomes. Results: The gestational age at birth in group A was (30.7 ± 2.4) weeks; the birth weight (1278.1 ± 142.1) g; the male-female ratio was 1.94, which was not significantly different from that in group B The prevalence of prenatal hormones (26% vs.7.6%, P <0.01) and the number of mothers and infants in the same room (44% vs.44%, P <0.01) 25%, P <0.01), and the rate of weight gain in the same room (24.1 ± 13.4 vs.11.7 ± 14.6, P <0.01). The rate of pulmonary surfactant (PS) ), Duration of mechanical ventilation (5d vs. 2d, P <0.01), peripheral PICC use rate (63% vs.13%, P <0.01), patent ductus arteriosus (PDA) 18.3%, P <0.01), the incidence of retinopathy of prematurity (13% vs.3.8%, P <0.05) and the incidence of bronchopulmonary dysplasia (20% vs.5.3%, P < Hospitalization days (40dvs.21d, P <0.01) and hospitalization costs (47 229 yuan vs.26 194 yuan, P <0.01) were significantly higher than those in group B. Group A discharged body weight, cure and improvement rates were significantly higher than the B group. Conclusion: Although there has been a great improvement in the treatment methods and effects of premature infants over the past five years, there are still some shortcomings in the aspects of prenatal hormone utilization rate, respiratory management, nutrition management and prevention and treatment of nosocomial infections. Sexual improvement, in the hope of further reducing the incidence of complications and mortality.