2004-2009年中日友好医院早产儿并发症的疾病构成变迁

目的 探讨我院早产儿并发症的疾病构成变迁,为今后临床预防和调整治疗重点提供科学依据.方法 2004年1月至2009年12月我院新生儿重症监护室共收治早产儿268例,回顾性统计早产儿并发症的发生情况,并按各年度分析并发症的疾病构成.结果 ①197例早产儿有并发症存在,并发症发生率73.51%(197/268).②最常见的并发症为新生儿高胆红素血症(41.62%,82/197)、新生儿缺氧缺血性脑病(39.59%,78/197)和新生儿吸入综合征(34.01%,67/197).③早产儿并发症的疾病构成变迁:近6年新生儿高胆红素血症在疾病构成中一直位居前3位(发生率在28.57%～75.76%,χ2=13.582,P<0.01);新生儿缺氧缺血性脑病的发生率呈上升趋势(由2004年10.71%升至2007年的56.25%,χ2=7.577,P<0.01),但2008、2009年又有所下降;新生儿吸入综合征的发生率一直较高但有所波动(15.15%～56.25%,χ2=12.002,P<0.001);新生儿低血糖症在近3年的发生率明显增高;新生儿窒息的发生率比较稳定;新生儿呼吸窘迫综合征的发生率上下波动较大(3.57%～20.41%,χ2=4.125,P<0.05);早产儿贫血的发生率呈上升趋势(3.03%～18.37%,χ2=4.332,P<0.05);新生儿硬肿症的发生率明显减少;早产儿患感染性疾病的比率较低.结论 早产儿并发症的疾病构成中以非感染性疾病为主.应进一步改进新生儿窒息复苏技术.早产儿出生后需及早监测血清胆红素浓度并及时干预.及时进行头颅影像学检查以早期发现脑损伤.

Change of the disease constitution of complication in preterm infants of China-Japan friendship Hospital from 2004 to 2009

Objective To analyze the change of disease constitution of complications in preterm infants in our hospital and to provide a scientific basis for the clinical prevention and treatment in the future. Methods Two hundred and sixty-eight preterm infants were admitted in NICU of our hospital from Jan. 2004 to Dec. 2009. The constitutions of complications in preterm infants were retrospectively analysed by year. Results One hundred and ninety-seven cases had complications and the incidence of complications was 73.51% ( 197/268 ). The most common complications of preterm infants in our hospital included neonatal hyperbilirubinemia (41. 62% ,82/197), neonatal hypoxic-ischemic encephalopathy (39. 59% , 78/197) and neonatal aspiration syndrome (34. 01%, 67/ 197). The change of disease constitution of the complications were as follows: the disease constitution of neonatal hyperbilirubinemia always located within the first 3 diseases ( ranged from 28. 57% to 75.76% , χ2 =13. 582, P < 0. 001) ;the occurrence of neonatal hypoxic-ischemic encephalopathy showed upward trend( increased from 10. 71% to 56. 25% ,χ2 =7. 577,P<0. 001) ,but decreased in 2008,2009;the neonatal aspiration syndrome presented with a high but fluctuant incidence among the 6 years (ranged from 15. 15% to 56. 25% ,x2=12.002,P < 0.001) ; the neonatal hypoglycemia increased in the nearly 3 years;the incidence of neonatal asphyxia was stationary;the disease constitution of neonatal respiratory distress syndrome fluctuated up and down( ranged from 3. 57% to 20.41% ,χ2 = 4. 125,P<0. 05) ;the anemia in premature infant showed upward trend,increasing from 3.03% to 18. 37% (χ2 = 4. 332,P< 0.05 ) ; the occurrence of neonatal scleredema decreased with no statistical significance; the preterm infants suffered from infectious diseases with lower rate. Conclusions The disease constitution of the hospitalized preterm infants in our hospital in the last 6 years is mainly non-infectious diseases. The neonatal asphyxia recovery technology should be further improved. The serum bilirubin concentration should be monitored early after birth of preterm infants and intervened timely. Cranial imaging studies should be performed timely for early detection of brain injury.