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[极早早产儿的生存及预后因素分析]

[Analysis of survival and prognostic factors in extremely preterm infants].

作者信息

Cui Yin-Zhu, Zhang Qian-Shen, He Hong-Yun, Chen Chun

机构信息

Neonatal Intensive Care Unit, Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, Guangdong 518028, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2014 Jun;16(6):596-600.

Abstract

OBJECTIVE

To investigate the survival rate, complications during hospitalization, and prognostic factors in extremely preterm infants (gestational age less than 28 weeks) in the neonatal intensive care unit (NICU).

METHODS

A retrospective analysis was performed on 90 extremely preterm infants who were admitted to the NICU between January 2011 and March 2013 to investigate the perinatal data, delivery and resuscitation, ventilation/oxygen supply during hospitalization, mortality, and the incidence of severe (grade III/IV) intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), retinopathy of prematurity (ROP), patent ductus arteriosus (PDA), and septicemia.

RESULTS

Among the 90 extremely preterm infants, the gestational age, birth weight, overall survival rate, mortality, and withdrawal rate were 26±1 weeks, 898±165 g, 57%, 9%, and 34%, respectively. The incidence rates of neonatal respiratory distress syndrome, BPD, PDA, ROP, and grade III/IV IVH were 88%, 85%, 69%, 68%, and 31%, respectively. The surviving infants had a mean length of hospital stay of 83±18 days and a mean weight at discharge of 2 419±300 g. The multivariate logistic regression analysis showed that grade III/IV IVH and pulmonary hemorrhage were high-risk factors for death or withdrawal, while antenatal corticosteroids were the protective factor for outcome (P<0.05).

CONCLUSIONS

The survival rate of extremely preterm infants is still much lower than that in developed countries. grade III/IV IVH, and pulmonary hemorrhage are important prognostic factors.

摘要

目的

探讨新生儿重症监护病房(NICU)中极早产儿(胎龄小于28周)的存活率、住院期间并发症及预后因素。

方法

对2011年1月至2013年3月入住NICU的90例极早产儿进行回顾性分析,以调查围产期数据、分娩及复苏情况、住院期间的通气/供氧情况、死亡率以及重度(III/IV级)脑室内出血(IVH)、支气管肺发育不良(BPD)、早产儿视网膜病变(ROP)、动脉导管未闭(PDA)和败血症的发生率。

结果

90例极早产儿的胎龄、出生体重、总体存活率、死亡率及放弃治疗率分别为26±1周、898±165 g、57%、9%和34%。新生儿呼吸窘迫综合征、BPD、PDA、ROP及III/IV级IVH的发生率分别为88%、85%、69%、68%和31%。存活婴儿的平均住院时间为83±18天,出院时平均体重为2419±300 g。多因素logistic回归分析显示,III/IV级IVH和肺出血是死亡或放弃治疗的高危因素,而产前使用糖皮质激素是预后的保护因素(P<0.05)。

结论

极早产儿的存活率仍远低于发达国家。III/IV级IVH和肺出血是重要的预后因素。

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