极低出生体重儿226例相关因素分析

目的探讨影响极低出生体重儿存活率的相关因素，为降低其病死率和病残率提供依据。方法对1999年9月～2005年9月收治的226例极低出生体重儿按体重分三组，对其临床资料进行回顾性分析。结果极低出生体重儿治愈出院170例，治愈率75．2％；随体重增加而上升（P〈0．05）；治愈者平均住院（27±13）d，住院天数随体重增加而缩短（P〈0．05）；病死30例，病死率13．2％；病死率随体重增加而下降（P〈0．01）。导致极低出生体重儿的主要原因有多胎妊娠（27．8％），胎膜早破（22．5％），妊娠并发症13．7％，习惯性流产2．6％，妊娠患内科慢性疾病（1．76％）和原因不明（31．6％）。所有住院患儿均有一种以上并发症，≤1000g的超低出生体重儿的发生率高达85．3％，其体重越低，并发症的发生率越高（P〈0．01），存活率85．1％，体重≤1000g，存活率56．3％。死亡的主要原因是肺出血，呼吸窘迫综合征，感染和颅内出血。结论提高极低出生体重儿必须收住NICU病房密切监护，早期发现并发症，并及时处理；防止院内感染；对呼吸窘迫综合征采用表面活性物质和高频通气治疗可以提高极低出生体重儿的存活率。

Analysis of Clinical Date of 226 Very Low Birth Weight Infants

Objective To investigate related factors of livability on Premature Very Low- Birth - Weight Infant （PVLBW1）, and to find evidences that reduce the mortality and the deformity rate. Methods 226 PVLBWL cases were divided into 3 groups. And made retrespective studies. （from 1999.9 to 2005.9）. Results There are 170 cases that had cured. The cure rate is 75.2 % （ 170/ 226）. It rises along with the weight increase（P〈0.05）. It is on average （29＋ 13）days of the treatment in hospital. It is shortened a long with the weigh increase（P〈0.05）. There is 30 infants in the group dead, the death rate is 13.2% （30/226）. It reduces along with increasing（P〈0.01 ）. The major reasons are excessive- embryo- pregnancy（27.8% ）, amnion - early- break（22.5% ）, combine- symptom in pregnancy（13.7% ）, practice - premature（2.6% ）, chronic illness in gestation（ 1.76% ） and unclear reason（31. 6 % ）. The infants in hospital all have more than one combine symptoms. It is 85.3 % in the group which weight ≤ 1000g. The lower weight, the more combine symptoms （P〈0.01 ）. The livability is 85.1% in the gruop; the livability is 56.3% in which weight 1000g. The mostly effect reasons of death are bleeding in lung, breathembarrassment, synthesis, infection and bleeding in encephalic. Conclusion To improve the near and far livability and reduce the mortality and the deformity rate of the VLBWI, and supervising care strictly, managing the combine symptom in time.