极低与超低出生体质量儿的临床分析

目的 探讨极低出生体质量（VLBW）儿和超低出生体质量（ELBW）儿的临床表现.方法 选择2012年8月至2013年8月于四川大学华西第二医院收治的103例VLBW儿和ELBW儿为研究对象.采用回顾性分析法,对母亲孕期致VLBW儿及ELBW儿的高危因素、患儿生后并发症治疗及转归进行总结和分析（本研究遵循的程序符合四川大学华西第二医院人体试验委员会制定的伦理学标准,得到该委员会批准,征得受试对象监护人的知情同意,并与之签署临床研究知情同意书）.结果 103例VLBW儿和ELBW儿的并发症前10位分别为：新生儿肺炎为85例（82.5％）、颅内出血（ICH）为79例（76.6％）、高胆红素血症为60例（58.2％）、呼吸暂停为59例（57.2％）、呼吸衰竭为54例（52.4％）、电解质紊乱为53例（51.4％）、酸碱平衡紊乱为47例（45.6％）、低血糖为40例（38.8％）、贫血为38例（36.9％）、新生儿呼吸窘迫综合征（NRDS）为28例（27.2％）.103例患儿中,存活为84例（81.6％）,死亡为8例（7.8％,放弃治疗后死亡为3例）,家属放弃治疗自动出院为11例（10.7％）.结论 及时、恰当地对VLBW儿和ELBW儿给予保暖、营养支持、积极预防并治疗各种早产儿相关并发症等,可降低其死亡率.

Clinical Analysis of Very Low Birth Weight Infants and Extremely Birth Weight Infants

Objective To investigate the clinical manifestations,treatment and hospitalized outcomes of very low birth weight（VLBW） infants and extremely low birth weight（ELBW） infants.Methods From August 2012 to August 2013,a total of 103 cases with VLBW and ELBW in West China Second University Hospital,Sichuan University were recruited into this study.Their clinical manifestations,risk-factors of pregnant women and complications of infants were analyzed respectively.The study protocol was approved by the Ethical Review Board of Investigation of West China Second University Hospital,Sichuan University.Informed consent was obtained from all participates parents.Results The following were the top ten complications of 103 cases,85 cases with neonatal pneumonia（82.5 ％）,79 cases with intracranial hemorrhage（ICH,76.6％）,60 cases with hyperbilirubinemia（58.2％）,59 cases with sleep apnea（57.2％）,54 cases with respiratory failure（52.4 ％）,53 cases with electrolyte disturbance （51.4 ％）,47 cases with acid base disturbance（45.6％）,40 cases with hypoglycemia （38.8％）,38 cases with anemia （36.9％）,28 cases with neonatal respiratory distress syndrome（27.2％）. In 103 cases,84 cases （81.6％） survived,8 cases died （7.8％,3 cases died after withdrawing medical treatment）,11 cases （10.7％） discharged from hospital.Conclusions Warmth retention,nutritional support,prevention and treatment of complications can contribute to reducing the incidence of mortality in premature infants.