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目的探讨晚期早产双胎新生儿(LPTs)及早期足月双胎新生儿(EETs)围产期常见临床并发症情况。方法对136例LPTs、32例EETs孕母情况及新生儿期并发症情况进行回顾性分析,对不同资料分别采用独立样本t检验、ANOVA检验或χ2检验等方法比较组间差异。结果 (1)晚期早产双胎组小于胎龄儿发生率明显低于早期足月双胎组(25.7%vs.59.4%,χ2=13.44,P=0.000)。(2)晚期早产双胎组孕母先兆子痫发生率明显高于早期足月双胎组(17.6%vs.0,χ2=6.588,P=0.010),前者自发宫缩发生率也明显高于后者(30.9%vs.6.3%,χ2=8.131,P=0.004)。(3)晚期早产双胎组新生儿发生新生儿贫血(76.5%vs.31.3%,χ2=24.287,P=0.000)、新生儿肺炎(67.6%vs.28.1%,χ2=16.876,P=0.000)、低体温(26.5%vs.9.4%,χ2=4.247,P=0.039)、新生儿低血糖症(24.3%vs.6.3%,χ2=5.097,P=0.024)、新生儿低白蛋白血症(17.6%vs.3.1%,χ2=4.313,P=0.038)、颅内出血(20.6%vs.0,χ2=7.906,P=0.005)、使用辅助通气(12.5%vs.0,χ2=4.45,P=0.035)等发生率均明显高于早期足月双胎组,同时前者住院时间也明显长于后者[(11.4±6.3)d vs.(6.3±3.4)d,t=4.27,P=0.000],差别均有统计学意义,而早期足月双胎组新生儿病理性黄疸发生率高于晚期早产双胎组(6.6%vs.12.5%,χ2=1.479,P=0.262),差别无统计学意义。(4)晚期早产双胎组中,随着胎龄的增加,新生儿呼吸窘迫综合征(12.5%vs.4.0%vs.0,χ2=7.061,P=0.029)、新生儿呼吸暂停(22.5%vs.22%vs.2.2%,χ2=9.375,P=0.009)、使用肺表面活性物质(20.0%vs.4.0%vs.4.3%,χ2=8.802,P=0.012)、使用辅助通气(25%vs.12%vs.2.2%,χ2=10.21,P=0.006)、新生儿低白蛋白血症(25%vs.22%vs.6.5%,χ2=6.058,P=0.048)、动脉导管未闭(30.0%vs.18%vs.6.5%,χ2=8.122,P=0.017)等发生率均逐渐降低,而新生儿湿肺发生率(0 vs.8.0%vs.15.2%,χ2=6.665,P=0.036)则逐渐升高,总住院时间随着胎龄增加逐渐缩短[(12.1±6.2)d vs.(12.8±7.4)d vs.(9.3±4.3)d,F=3.929,P=0.022],差别均有统计学意义。结论晚期早产双胎儿发生多数新生儿期并发症的概率高于早期足月双胎儿,尤其以呼吸系统和代谢性并发症为著,同时随着胎龄的增加,各种新生儿期并发症发生率逐渐降低,应重视及加强对晚期早产双胎儿新生儿期的监测,及时发现并治疗常见新生儿短期并发症,避免出现严重并发症。
Objective To investigate the perinatal common clinical complications of late preterm twins (LPTs) and early full term twins (EETs). Methods Retrospective analysis was performed on 136 pregnant women with LPTs, 32 pregnant women with EETs and neonatal complications. The differences between groups were compared using independent samples t test, ANOVA test or χ2 test for different data. Results (1) The incidence of twins in late preterm birth less than gestational age was significantly lower than that in early term twins (25.7% vs. 59.4%, χ2 = 13.44, P = 0.000). (2) The incidence of pre-eclampsia in preterm twins was significantly higher than that in early term twins (17.6% vs.0, χ2 = 6.588, P = 0.010). The incidence of spontaneous uterine contractions The latter (30.9% vs.6.3%, χ2 = 8.131, P = 0.004). (3) Neonatal anemia (76.5% vs.31.3%, χ2 = 24.287, P = 0.000), neonatal pneumonia (67.6% vs.28.1%, χ2 = 16.876, P = 0.000) , Hypothermia (26.5% vs 9.4%, χ2 = 4.247, P = 0.039), neonatal hypoglycemia (24.3% vs.6.3%, χ2 = 5.097, P = 0.024), neonatal hypoalbuminemia (12.5% vs.0, χ2 = 4.45, P = 0.008), and the rate of intracranial hemorrhage (20.6% vs.0, χ2 = 7.906, P = 0.005) 0.035) were significantly higher than those of the early full-term twin group, while the former also significantly longer hospital stay than the latter [(11.4 ± 6.3) d vs. (6.3 ± 3.4) d, t = 4.27, P = 0.000] The difference between the two groups was statistically significant, but the incidence of neonatal pathological jaundice in early full-term twins was higher than that of the twins with advanced preterm birth (6.6% vs. 12.5%, χ2 = 1.479, P = 0.262) . (4) Neonatal respiratory distress syndrome (12.5% vs.4.0% vs.0, χ2 = 7.061, P = 0.029), neonatal apnea (22.5% Pulmonary surfactant (20.0% vs.4.0% vs.4.3%, χ2 = 8.802, P = 0.012), with adjunct ventilation (25% vs2.2%, χ2 = 9.375, P = 0.009) (12% vs.2.2%, χ2 = 10.21, P = 0.006), neonatal hypoalbuminemia (25% vs.22% vs.6.5%, χ2 = 6.058, P = 0.048), patent ductus arteriosus (30.0% vs.18% vs.6.5%, χ2 = 8.122, P = 0.017), but the incidence of neonatal wet lung (0 vs.8.0% vs.15.2%, χ2 = 6.665, P = 0.036), and the total length of hospital stay decreased with increasing gestational age [(12.1 ± 6.2) d vs. (12.8 ± 7.4) d vs. (9.3 ± 4.3) days, F = 3.929, P = 0.022) , The differences were statistically significant. Conclusion The incidence of most neonatal complications in preterm twins is higher than that in early full term fetuses, especially respiratory and metabolic complications. Various neonatal complications occur with the increase of gestational age The rate gradually decreased, should pay attention to and strengthen the monitoring of neonatal twin premature twins, timely detection and treatment of common neonatal short-term complications, to avoid serious complications.