资源匮乏的非洲医院中极低出生体重婴儿的早期出院：一项随机试验。

Earlier discharge of very low birthweight infants from an under-resourced African hospital: a randomised trial.

作者信息

Mokhachane Mantoa, Saloojee Haroon, Cooper Peter A

机构信息

Neonatal Unit, Department of Paediatrics and Child Health, Chris Hani Baragwanath Hospital, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Ann Trop Paediatr. 2006 Mar;26(1):43-51. doi: 10.1179/146532806X90600.

DOI:10.1179/146532806X90600

PMID:16494704

Abstract

BACKGROUND

Very low birthweight (VLBW) infants contribute substantially to the workload and expenditure of any neonatal unit. Earlier discharge might offer advantages to the infant, the family and the health service.

AIM

To establish the outcome of preterm, VLBW infants discharged at a weight of > or = 1650 g compared with the unit's practise of discharging at a weight of > or = 1800 g.

METHODS

A total of 120 infants (62 early discharges, 58 routine discharges) were followed up for 3 months after discharge from Chris Hani Baragwanath Hospital in Soweto, South Africa. The early-discharge group was discharged at > or = 1650 g and the routine-discharge group at > or = 1800 g. Growth, morbidity and mortality at 1 and 3 months after discharge were compared.

RESULTS

At 3 months, the rate of weight gain (mean 30 vs 33 g/kg/day, p=0.06) and head circumference growth (38.9 vs 39.5 cm, p=0.10) were similar in both groups. There were no differences between the early- and routine-discharge groups in the number of outpatient visits (24 vs 16, p=0.18), frequency of re-admission (9 vs 4, p=0.17) or mortality [1 (1.6%) vs 3 (5.2%), p=0.27] following discharge.

CONCLUSION

If home circumstances are adequate, it is as safe to discharge well, singleton VLBW infants from hospital at a weight of > or = 1650 g as at > or = 1800 g.

摘要

背景

极低出生体重（VLBW）婴儿给任何新生儿病房带来了巨大的工作量和支出。较早出院可能对婴儿、家庭和医疗服务都有好处。

目的

确定体重≥1650克时出院的早产极低出生体重婴儿的结局，并与该病房体重≥1800克时出院的常规做法进行比较。

方法

对南非索韦托克里斯·哈尼·巴拉格瓦纳特医院出院的120名婴儿（62名早期出院，58名常规出院）进行了出院后3个月的随访。早期出院组在体重≥1650克时出院，常规出院组在体重≥1800克时出院。比较出院后1个月和3个月时的生长、发病率和死亡率。

结果

在3个月时，两组的体重增加率（平均每天30对33克/千克，p=0.06）和头围生长（38.9对39.5厘米，p=0.10）相似。早期出院组和常规出院组在出院后的门诊就诊次数（24对16，p=0.18）、再次入院频率（9对4，p=0.17）或死亡率[1例（1.6%）对3例（5.2%），p=0.27]方面没有差异。