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病例报告:极低出生体重(低于300克)早产儿的治疗:病例系列

Case Report: Treatment of Extremely Preterm Infants With Birthweight Below 300 g: Case Series.

作者信息

Shitara Yoshihiko, Kakiuchi Satsuki, Mukai Takeo, Kashima Kohei, Kato Motohiro, Takahashi Naoto

机构信息

Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan.

出版信息

Front Pediatr. 2021 Dec 6;9:758683. doi: 10.3389/fped.2021.758683. eCollection 2021.

Abstract

Reports on the birth of infants weighing <300 g are quite rare and little is known about the best practices in treating such micropreemies. Therefore, we report here on three cases of low birthweight infants weighing <300 g, of whom two infants survived. The birthweights and gestational ages were ranging 279-293 g and 22 + 6/7 - 23 + 6/7 weeks, respectively. All the infants had severe fetal growth restriction and prematurity. The infant in case 1 died of hepatic rupture, perhaps due to birth trauma, which emphasized the need for less invasive obstetric procedures including delivery. The infant in case 2 managed to survive through severe prematurity secondary to hydrops fetalis. However, complications followed soon as tracheal granulation tissue was formed with neurodevelopmental impairment. The infant in case 3 was born recently and her clinical course was less remarkable without severe complications, despite having the least gestational age and birthweight among the three patients. The improved care protocols for extremely low birthweight infants over these years through experiential learning including that with cases 1 and 2 may have ensured the better outcome of case 3. Accumulating evidence and recording the experience of such cases with continuous constructive discussion can contribute to better outcomes and appropriate parental counseling for extremely small babies in the future.

摘要

关于出生体重小于300克婴儿的报道相当罕见,对于治疗此类超低体重早产儿的最佳做法知之甚少。因此,我们在此报告三例出生体重小于300克的低体重婴儿病例,其中两名婴儿存活。出生体重和胎龄分别在279 - 293克和22 + 6/7 - 23 + 6/7周之间。所有婴儿均有严重的胎儿生长受限和早产情况。病例1中的婴儿死于肝破裂,可能是由于出生时的创伤,这强调了包括分娩在内的侵入性较小的产科操作的必要性。病例2中的婴儿因胎儿水肿继发严重早产而存活。然而,随后很快出现并发症,形成气管肉芽组织并伴有神经发育障碍。病例3中的婴儿最近出生,尽管她是三名患者中胎龄和出生体重最小的,但她的临床过程没有严重并发症,情况相对较好。这些年来,通过包括病例1和病例2在内的经验学习,改进了极低出生体重婴儿的护理方案,这可能确保了病例3的较好预后。积累证据并通过持续的建设性讨论记录此类病例的经验,可为未来极小婴儿取得更好的治疗结果和为家长提供适当的咨询提供帮助。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f79c/8685408/fa23aa428bd6/fped-09-758683-g0001.jpg

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