Objective:To analyze the clinical features and prognosis of extremely low birth weight infant (ELBW)and very low birth weight infants(VLBW). Methods:Data of totally 223 hospitalized ELBWI/VLBWI in department of neonatology of our hospital were analyzed. The information of general data and births, prenatal care, complications and outcome were summarized. Results:(1) 223 ELBWI/VLBWI were involved, their mean gestational age was (30.19±0.15) weeks, mean birth weight was (1224±12.35)g. (2) Rate of natural conception was 78.92%(176/223),rate of in-vitro fertilization was 21.08% (47/223). Rate of single birth was 64.57% (144/223), rate of multiple births was 35.43%(79/223). Rate of premature rupture of membranes(PROM) was 32.29% (72/223), pregnancy-induced hypertension syndrome was 0.18%(45/223), gestational diabetes mellitus was 4.04% (9/223). (3) Rate of prenatal steroids exposure was 22.87% (51/223).None of the cases were treated with continuous positive airway pressure (CPAP) in delivery room. (4) Their main complication included neonatal respiratory distress syndrome(NRDS,47.53%,106/223), bronchopulmonary dysplasia(BPD,4.93%,11/223), preterm retinopathy(ROP,18.63%,19/102), patent ductus arteriosus(PDA,26.91%,60/223), intraventricular hemorrhage(IVH,92.38%,206/223), sepsis(43.05%,96/223). (5) Rate of cured cases was 70.85%(158/223, treatment was given up in 22.87%(51/223), total mortality was 6.28%(14/223). Rate of extrauterine growth retardation(EUGR) was 57.40%(128/223). Conclusion:The number of ELBWI/VLBWI has increased dramatically. Reduction of PROM, antenatal steroids, noninvasive respiratory support, early screening of ROP and optimal nutrition supports are key factors of improving the survival rate and long-term outcomes of ELBWI/BLBWI. |
[1] SAIGAL S,曹云.极低和超低出生体重早产儿远期预后[J].中国循证儿科杂志,2007,2(5):321-326.
[2] 许植之,秦振庭.我国新生儿疾病临床回顾与展望[J].新生儿科杂志,2001,16(5):224-230.
[3] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].4版.北京:人民卫生出版社,2011:375-773.
[4] FENTON T R.A new growth chart for preterm babies:Babson and Benda's chart updated with recent data and a new format[J].BMC Pediatr,2003,3(1):13.
[5] 中华医学会儿科学分会新生儿学组.中国住院新生儿流行病学调查[J].中国当代儿科杂志,2009,11(1):15-20.
[6] 陈凌.早产儿肺炎发病的相关因素分析[J].现代医学,2016,44(2):223-227.
[7] SWEET D G,CARNIELLI V,GREISEN G,et al.European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update[J].Neonatology,2013,103:353-368.
[8] VISCARDI R M.Perinatal inflammation and lung injury[J].Semin Fetal Neonatal Med,2012,17(1):30-35.
[9] 早产儿支气管肺发育不良调查协作组.早产儿支气管肺发育不良发生率及高危因素的多中心回顾调查分析[J].中华儿科杂志,2011,49(9):622-655.
[10] 赵有为,傅万海.早产儿视网膜病的影响因素[J].中华实用儿科临床杂志,2011,26(8):600-601,615.
[11] 中国内地新生儿专业发展现状调查协作组.国内109家医院早产儿视网膜病防治现状调查[J].中华实用儿科临床杂志,2013,28(2):86-88.
[12] 冯天行,王来栓.早产儿动脉导管未闭的导管关闭治疗[J].中华儿科杂志,2011,49(10):761-764.
[13] 陈涵强,杨长仪,杨文庆,等.极低出生体重早产儿动脉导管未闭的治疗[J].中华围产医学杂志,2011,4(7):524-530.
[14] 林新祝,陈涵强,郑直,等.早期口服布洛芬治疗极低出生体重儿动脉导管未闭的临床研究[J].中国当代儿科杂志,2012,14(7):502-505.
[15] 彭小明,高喜容,孙正香,等.早产儿重度脑室周围-脑室内出血临床高危因素分析[J].中国新生儿科杂志,2011,26(6):386-388.
[16] 朱梅英,顾敏贞.极低出生体重儿坏死性小肠结肠炎发生率和高危因素分析[J].中国新生儿科杂志,2012,27(2):78-81.
[17] STOLL B J,HANSEN N I,BELL E F,et al.Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network[J].Pediatrics,2010,126:443-456.
[18] 母乳强化剂应用研究协作组.母乳强化剂在早产儿母乳喂养中营养的多中心研究[J].中华儿科杂志,2012,50:336-342.
[19] 刘江勤,黄丽萍,严虎,等.极低出生体重早产儿143例结局[J].中国新生儿科杂志,2012,27(4):243-246.
[20] 王恋,李娟,毛健,等.极低及超低出生体重儿的预后因素分析[J].中国当代儿科杂志,2014,16(6):601-605. |
