47例超低出生体重儿的治疗和管理的临床体会

目的探讨提高超低出生体重儿(ELBWI)的治愈率及减少并发症的方法。方法回顾性分析不同时间段(2002年1月-2011年9月)47例ELBWL的住院经过及临床预后。结果近5年ELBW存活率较前5年有显著上升(46.4%vs 11.8%,P=0.01);最常见的合并症仍然是新生儿感染(74.5%)、早产儿贫血(66.0%)、高胆红素血症(55.3%)、呼吸窘迫综合症(51.1%)及呼吸暂停(51.1%)等;而硬肿症及动脉导管未闭的发生率明显降低。结论近年来ELBWI的治愈率明显提高,但其死亡率仍维持在较高水平;而加强科学护理、严密监测生命体征变化、预防感染、合理喂养等措施是提高ELBWI早期生存率的关键。

The Clinical Experience of 47 Extremely Low Birth Weight Infants

Objective To investigate management of improving survive and minimizing complications of extremely low birth weight infants(ELBWI).Methods 47 ELBWI between January 2002 and September 2011 were enrolled.The cases were divided into two groups based on different years and clinical outcomes were analyzed retrospectively.Results Among the 47 cases,the survival rate of ELBWI in recent 5 years had extremely improved compared with those in 5 years before(46.4% vs 11.8%,P<0.01).The most common complications of ELBWI were still infection(74.5%),anemia(65.9%),hyperbilirubinemia(55.3%),RDS(51.1%)and apnea(51.1%).The incidence of sclerema and PDA decreased recently.Conclusion Although the survival of ELBW in last 5 years demonstrated definite improvement,the mortality remained high.The key to improve the survival rate of ELBWI was to strengthen the intensive care,close monitor of vital signs,prevent infection and feed reasonably.