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极低出生体重早产儿出院后的医疗需求:一项基于台湾地区人群的研究。

Medical Needs of Very-Low-Birth-Weight Preterm Infants Post-Discharge: A Population-Based Study in Taiwan.

作者信息

Chang Jui-Hsing, Chen Chia-Huei, Peng Chun-Chih, Lin Chia-Ying, Chang Hung-Yang, Hsu Chyong-Hsin, Jim Wai-Tim

机构信息

Division of Neonatology, Department of Pediatrics, MacKay Children's Hospital, Taipei City, Taiwan.

Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.

出版信息

Neonatology. 2025 May 7:1-9. doi: 10.1159/000546115.

Abstract

INTRODUCTION

The aim of this study was to explore the outcomes, home use of medical assistive devices, and interdisciplinary medical needs of very-low-birth-weight (VLBW) infants at a corrected age of 2 years.

METHODS

Analyses were performed using perinatal, neonatal, and 2-year follow-up data from VLBW infants registered in the Taiwan Premature Infant Follow-up Network (TPFN) between 2011 and 2017. Basic information, survival, and disease conditions during hospitalization were recorded. Medical needs at discharge, outcomes at a corrected age of 2 years, active involvement in outpatient healthcare services, and referrals were investigated.

RESULTS

From 2011 to 2017, a total of 9,243 VLBW preterm neonates were enrolled in the TPFN. Of these neonates, 140 had severe congenital anomalies, 8,044 survived to discharge, and 6,150 returned for follow-up evaluation. At discharge, 10.2% of infants received home oxygen therapy (HOT), and 6.5% used home monitoring devices. Among the infants diagnosed with chronic lung disease, 26.6% received HOT. At a corrected age of 2 years, the most common interventions and recommended referrals were rehabilitative treatments (34.5%), followed by early intervention system services (16.5%), ophthalmology/otolaryngology management (4.4%), neurological follow-up (4.1%), and mental health assessment and treatment (2.5%).

CONCLUSION

After hospital discharge, VLBW preterm infants exhibit substantial healthcare needs, with significant demands of HOT, rehabilitation, and early intervention services by a corrected age of 2 years. These findings highlight the importance of coordinated outpatient care and long-term follow-up to address the developmental and medical challenges faced by this vulnerable population.

摘要

引言

本研究旨在探讨极低出生体重(VLBW)婴儿在2岁矫正年龄时的预后、医疗辅助设备的家庭使用情况以及跨学科医疗需求。

方法

利用2011年至2017年在台湾早产儿随访网络(TPFN)登记的VLBW婴儿的围产期、新生儿期和2年随访数据进行分析。记录基本信息、住院期间的生存情况和疾病状况。调查出院时的医疗需求、2岁矫正年龄时的预后、积极参与门诊医疗服务的情况以及转诊情况。

结果

2011年至2017年,共有9243例VLBW早产儿纳入TPFN。其中,140例有严重先天性异常,8044例存活至出院,6150例返回进行随访评估。出院时,10.2%的婴儿接受家庭氧疗(HOT),6.5%使用家庭监测设备。在被诊断为慢性肺病的婴儿中,26.6%接受HOT。在2岁矫正年龄时,最常见的干预措施和推荐转诊是康复治疗(34.5%),其次是早期干预系统服务(16.5%)、眼科/耳鼻喉科管理(4.4%)、神经学随访(4.1%)以及心理健康评估和治疗(2.5%)。

结论

出院后,VLBW早产儿表现出大量的医疗需求,在2岁矫正年龄时对HOT、康复和早期干预服务有显著需求。这些发现凸显了协调门诊护理和长期随访以应对这一脆弱人群所面临的发育和医疗挑战的重要性。

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