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??Objective??To find the difference in growth and development of children between full-term symmetric growth restriction??FSGR?? and full-term asymmetric growth restriction??FAGR?? through a general investigation of children born small for gestational age in Shanghai. Methods??This general investigation covered all children under 6 years old in Shanghai. Data on growth were retrospectively obtained from medical records. The P10 of birth head circumference/birthweight of the same gestational age and gender was used to distinguish FSGR and FAGR. Results??The sample contained 10 188 full-term SGA children among whom 8049 were FAGR and 2139 were FSGR. Up to 3 years old??both FSGR and FAGR failed to catch up in weight??height??head circumference and chest circumference. Growth restriction in FAGR was more serious. Significant difference could be seen in weight??t??-3.412??P??0.001?? and chest circumference??t??-2.526??P??0.012?? between FSGR and FAGR at 3 years old. Regarding growth speed??the growth rate of weight ??t??6.272??P??0.001????height ??t??9.143??P??0.001????head circumference ??t??6.063??P??0.001?? and chest circumference ??t??6.617??P??0.001?? were higher in FAGR 6 months after birth??while there was no difference after that. The BMI of FAGR was significantly lower than FSGR before 2 years old. The proportion of children in danger of being overweight was significantly higher in FSGR ??P??0.001??. Conclusion??Both FSGR and FAGR experience catch-up growth after birth??but not enough to catch up with normal children at 3 years old??especially in head circumference. In spite of severer growth restriction??the cath-up growth model of FAGR is superior to FSGR. The proportion of children in danger of being overweight is significantly higher in FSGR.     

全身运动质量评估对足月脑损伤儿脑瘫发育结局的预测价值

目的 研究全身运动(general movements, GMs)质量评估技术在足月脑损伤儿脑瘫发育结局中的预测价值。方法 回顾性纳入在复旦大学附属儿科医院康复科就诊的足月脑损伤儿55例, 所有研究对象均进行GMs评估并至少有一次不安运动阶段的评估, 随访至1周岁后根据临床神经学表现及Peabody运动发育量表(PDMS-2)明确其运动发育结局, 分析GMs评估对脑性瘫痪发育结局的预测敏感性、特异性、阳性预测值及阴性预测值。结果 纳入研究的55例足月脑损伤儿的GMs评估中, 20例为不安运动缺乏, 35例为不安运动存在。随访结局:1周岁后19例临床诊断为脑性瘫痪, 36例临床诊断为非脑性瘫痪。GMs评估(不安运动阶段)对足月脑损伤儿是否发展成为脑性瘫痪的预测效度为:敏感性89%、特异性92%、阳性预测值85%、阴性预测值94%。结论 GMs评估对于足月脑损伤儿的远期运动发育结局(是否发育为脑性瘫痪)具有良好的预测价值, 作为一种非侵入性、非干扰性的新型神经运动评估工具, GMs评估适合在足月脑损伤儿随访工作中推广应用。     

出生体重大于2000g新生儿眼底筛查结果分析

目的探讨出生体重大于2000g的新生儿眼底疾病的发生情况及开展早产儿视网膜病筛查的必要性。方法用双目间接眼底镜和（或）RetCamⅢ对2012年出生的636例新生儿进行眼底筛查,按胎龄分为两组（胎龄≥37周组和胎龄〈37周组）,分析比较各种眼底疾病的发生及救治情况。结果总患病概率为12．89％。其中最常见的眼底病变为视网膜出血（占8．65％）、早产儿视网膜病（占2．20％）和玻璃体混浊（占0．94％）。结论这类新生儿最常见眼底疾病为视网膜出血,顺产新生儿发生率高于剖宫产新生儿。积极地开展眼底筛查,进行随访很有必要。     

237例地诺前列酮栓用于足月初产妇和经产妇促宫颈成熟的临床研究

目的 探讨足月经产妇使用地诺前列酮栓促宫颈成熟的置药特点、引产特征和安全性,以指导其临床应用.方法 回顾性分析首都医科大学附属北京世纪坛医院产科2019年1～10月收治的237例Bishop评分≤6分、阴道放置地诺前列酮栓促宫颈成熟的足月妊娠孕妇资料,其中经产妇34例,初产妇203例,比较两组产妇的置药时长、取药原因、...     

足月妊娠羊水过少151例临床分析

目的探讨足月妊娠羊水过少的相关因素及其对妊娠结局的影响。方法对足月妊娠羊水过少151例孕妇及胎儿的临床资料进行回顾性分析。结果在妊娠足月时羊水过少发生率随妊娠周数的增加而增加,羊水过少组中妊娠期高血压、胎儿宫内生长迟缓及胎儿监护异常的发生率高于对照组,羊水粪染率、胎儿窘迫及新生儿窒息率增高。结论足月妊娠羊水过少经确诊后应及时终止妊娠,放宽剖宫产指征可改善新生儿预后,降低不良妊娠结局。     

晚期妊娠引产失败分析

目的分析某院10年间晚期妊娠引产失败的原因。方法对有高危因素具有阴道分娩条件的孕妇采用单纯催产素点滴引产或先后采用多种方法引产。结果引产失败的是宫颈不成熟、胎儿体重偏大、羊水过少、宫缩乏力产后出血,无新生儿窒息;结论引产并不增加母儿并发症,宫颈不成熟、羊水过少及胎儿体重偏大是引产失败的主要原因。     

早产儿与足月儿在1岁以内体格发育比较

目的了解早产儿在受到干预后的体格生长发育情况,且与足月儿比较,看能否追赶上足月儿,为今后评价早产儿的发育提供一些依据。方法按整群抽样法对2000～2006年在西南医院做过儿童保健检查的106例早产儿及106例正常足月儿的体格发育资料进行统计归纳,进行独立样本t检验。结果早产儿体重在出生时存在显著差异性(Ρ<0.01),2、4月龄时存在差异性(Ρ<0.05),6月龄后差异无显著性(P>0.05);身高、头围在2、4月龄时存在差异性(Ρ<0.05),6月龄后差异无显著性(P>0.05);胸围、血红蛋白在2月龄时存在差异性(Ρ<0.05),4月龄后差异无显著性(P>0.05);早产儿由于孕期短,出生时和出生后2～4月体格发育低于足月儿。结论早产儿在受到干预后的体格发育能良好的生长,且有一个快速的追赶期,最佳时期是1岁以内,特别是前半年,并且能追赶上足月儿,故家长们只要采取科学的喂养方法及按时做儿童保健检查,接受专业医生的正确指导,早产儿是能够健康成长的。     

Foley尿管水囊联合缩宫素用于足月妊娠促宫颈成熟的有效性、安全性和对产程的影响#br#

Objective?To explore the application effectiveness and safety of Foley catheter water bag combined with oxytocin in promoting cervical ripening and its influences on stages of labor in full-term pregnancy. Methods?A total of 102 full-term pregnant women with induced labor indications in Obstetrics Department of our hospital were enrolled between June 2017 and January 2021. According to different treatment methods by their willingness, they were divided into control group (51 cases, oxytocin) and combination group (51 cases, Foley balloon combined with oxytocin). Before induced labor and after intervention, cervical ripening effects in both groups were observed. The effect of cervical ripening before labor induction and after intervention in the two groups was observed, and the labor process and maternal and infant outcomes were compared between the two groups. Results?After intervention, Bishop scores were significantly higher than those before induced labor in both groups, which were significantly higher in combination group than control group (P<0.05). The first stage of labor and total stage of labor in combination group were significantly shorter than those in control group (P<0.05). The successful rate of labor induction and vaginal delivery in the combined group were higher than those in the control group, and the rates of postpartum hemorrhage and soft birth canal tearing were lower than those in the control group (P<0.05). The neonatal Apgar score in combination group was higher than that in control group (P<0.05). Conclusion?Foley catheter water bag combined with oxytocin can effectively and safely promote cervical ripening and shorten stages of labor in full-term pregnant women.     

妊娠晚期糖尿病患者胰岛素抵抗与胰岛素分泌的临床研究

目的探究妊娠晚期糖尿病患者与正常足月妊娠产妇的胰岛素抵抗情况与胰岛素分泌功能的差异,并为临床治疗提供实践性导向。方法选取深圳市观澜人民医院于2010年4月至2013年4月收治的72例妊娠晚期糖尿病患者作为妊娠糖尿病组;选取80例同期住院足月妊娠产妇作为妊娠健康组。比较两组产妇胰岛素抵抗指数、胰岛素分泌指数及妊娠结局情况。结果妊娠糖尿病组的空腹胰岛素(FINS)、ΔI60、胰岛素分泌指数(ΔI60/ΔG60)及β细胞功能指数(HOMA-β)分别为(3.63±0.38)pmol/L、(5.02±0.95)pmol/L、(3.52±0.06)、(6.70±0.11)%,妊娠健康组FINS、ΔI60、ΔI60/ΔG60、HOMA-β分别为(4.51±0.37)pmol/L、(5.96±0.78)pmol/L、(4.50±0.08)、(8.79±0.12)%,妊娠糖尿病组上述各指标均低于健康组,差异有统计学意义(P<0.05)。妊娠糖尿病组胰岛素抵抗指数为(3.42±0.05),妊娠健康组为(2.65±0.02),妊娠糖尿病组显著高于妊娠健康组,差异有统计学意义(P<0.05)。妊娠糖尿病组不良妊娠结局发生率不良妊娠结局发生率显著高于妊娠健康组(61.0%vs 13.9%),差异有统计学意义(P<0.05)。结论妊娠晚期糖尿病患者存在一定程度的胰岛素抵抗和胰岛素分泌缺陷,在围生期应实施必要的监测和治疗,以改善不良妊娠结局。     

RENAL FUNCTION IN INFANTS WITH HYPERBILIRUBINEMIA

Abstract. Broberger, U. & Aperia, A. (Departments of Paediatrics at Karolinska Sjukhuset and St. Göran's Children's Hospital, Stockholm, Sweden). Renal function in infants with hyperbilirubinemia. Acta Paediatr Scand, 68, 1979.—A total of 45 infants were studied on the fourth or fifth day of life: 13 term and 10 pre-term infants with serum bilirubin levels ranging between 257 and 390 µmol/l were compared with 12 term and 10 pre-term infants with serum bilirubin levels below 195 µmol/l. The groups did not differ with regard to mean gestational age or mean post-natal age. GFR and C_PAH were determined with the single injection clearance method and ability to excrete Na⁺ was determined following an oral loading of sodium chloride. GFR was lower in infants with hyperbilirubinemia and correlated negatively to the highest recorded serum bilirubin value. C_PAH was similar in hyperbilirubinemic infants and controls. The urinary sodium excretion was significantly higher in infants with hyperbilirubinemia.