150例极低出生体重儿的转归分析

目的探讨极低出生体重儿的临床特点和转归的相关因素。方法分析150例极低出生体重儿的发病原因、并发症、治疗转归。结果造成极低出生体重儿的主要原因有,多胎妊娠58例（38.7%）,胎膜早破45例（30%）,妊娠合并症36例（24%）,胎盘异常28例（18.6%）,24例（16.8%）原因不明。高胆红素血症、呼吸暂停、贫血、感染、呼吸窘迫综合征是其常见并发症。本组150例患儿中89例（59.3%）治愈出院,20例（13.3%）好转,34例（22.7%）放弃治疗,7例（4.7%）死亡。不同胎龄、体重、出生有无窒息史,预后均有显著差异（P〈0.05）。logistic回归分析发现,与预后有关的危险因素为胎龄的回归系数16.632,体重10.511、呼吸窘迫综合征8.114、呼吸暂停8.133。结论加强孕期保健和极低出生体重儿的密切监护,早期发现并妥善处理并发症,有助于提高极低出生体重儿的存活率和生存质量。

A retrospective analysis of the clinical characteristics of 150 very low birth weight infants

Objective This paper focuses on clinic characteristics and relative factors of outcomes in VLBWI.Methods To analyze the illness causes,complication and outcome of VLBWI.Results The main factors causing VLBWI are the following：58 multiple pregnancy（38.7%）,45 premature rupture of fetal membranes（30%）,36 complication of pregnancy（24%）,28 placental abnormality（18.6%）and 24 for unknown reasons（16%）.Hyperbilirubinemia,apnoea,anaemia,infection and respiratory distress syndrome were its usual complication.Among 150 cases of VLBWI,89（59.3%）cases recovered,20 cases（13.3）cases improving,34 cases（22.7%）giving up the treatment and 7（4.7%）cases dead.Different gestational age,weight,and the illness history of asphyxia gave prognosis different results.Logistic outcome analysis shows that the dangerous factor associated with prognosis is the outcome coefficient of 16.632 for gestational age,10.511 for weight,8.133 for apnoea,and 8.144 for respiratory distress syndrome.Conclusion It will help to improve the surviving rate and growth quality of VLBWI,to and strengthen the health protection in the pregnancy and close wardship for VLBWI and to find the syndrome beforehand and take proper measure to deal with it.