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[对一组56名出生体重低于1500克的婴儿进行的纵向研究:与重症监护技术进展相关的死亡率和神经后遗症]

[Longitudinal study of a group of 56 infants with a birth weight of less than 1500 gms: mortality and neurological sequelae in relation to progress in intensive care technics].

作者信息

Dellacorna P, Piccini V, Colnaghi C, Pelti M, Magni L A

出版信息

Pediatr Med Chir. 1983 Nov-Dec;5(6):537-42.

PMID:6687320
Abstract

56 very low-birth-weight (less than or equal to 1500 gm) infants were admitted in our Neonatal Intensive Care Unit between january 1978 and december 1981. Mortality of these infants in the first year of life decreased from 50% in 1978 to 32% in 1981. Our study confirms that mortality is significantly higher in transported infants. As to those born in our Hospital, mortality is markedly higher for breech delivery than for cephalic delivery or caesarian section. The amelioration of intensive care techniques, i.e. continuous transcutaneous PaO2 monitoring, orotracheal intubation at birth and improved respiratory care, markedly reduced the percentage of children with neuromotor pathology (from 43% in 1978 to 0% in 1981 in 16 survivors). Neurological follow-up was performed by serial controls until at least 2 years of age; Apgar scores and blood gas values are reported along with follow-up results to evaluate prognostic significance. Duration of orotracheal intubation, isolette requirement and feeding schedules are briefly discussed.

摘要

1978年1月至1981年12月期间,56名极低出生体重(小于或等于1500克)的婴儿被收治入我们的新生儿重症监护病房。这些婴儿在出生后第一年的死亡率从1978年的50%降至1981年的32%。我们的研究证实,转运婴儿的死亡率显著更高。对于那些在我们医院出生的婴儿,臀位分娩的死亡率明显高于头位分娩或剖宫产。重症监护技术的改进,即持续经皮监测动脉血氧分压、出生时经口气管插管以及改善呼吸护理,显著降低了神经运动病理学患儿的比例(在16名存活者中,从1978年的43%降至1981年的0%)。对患儿进行了系列对照的神经学随访,直至至少2岁;报告了阿氏评分和血气值以及随访结果,以评估其预后意义。简要讨论了经口气管插管的持续时间、暖箱需求和喂养方案。

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