极低出生体重儿113例临床分析

目的观察极低出生体重儿的临床特点及治疗转归。方法对113例极低出生体重儿的发病原因、转归、并发症的发生率、死亡原因等进行分析，总结其临床特点及诊治经验。并按出生体重分成3组，按胎龄分成大于30周和小于30周2组，比较其病死率。结果导致极低出生体重儿的主要原因有多胎妊娠、妊娠合并症、胎膜早破、高龄产妇和原因不明等。所有患儿均有一种或多种并发症，主要为低体温、呼吸暂停、低钙血症、早产儿贫血、感染性肺炎、高胆红素血症、肺透明膜病（RDS）、高血糖、喂养不耐受等。本组极低出生体重儿的存活率为73，5％，死亡率为23．9％。胎龄大于30周患儿的病死率明显低于胎龄小于30周者，两者比较差异有统计学意义（P〈0.05）。病死率随体重增加而降低（P〈0．05）。结论对极低出生体重儿必须密切监护，早期发现并及时处理并发症，从而提高极低出生体重儿的存活率和生存质量。

Clinical Analysis of Very Low Birth Weight Infants:a Report of 113 Cases

Objective To study the clinical characteristics and outcomes of very low birth weight infants （VLBWIs）. Methods The clinical data of 113 VLBWIs were analyzed retrospectively, The causes,outcomes,incidence of complications and the causes of death were analyzed, and the clinical features and the experience of treatment were summarized, Patients were divided into three groups according to their birth weights,and also were classified as two groups according to their gestational ages（ 〉 30 weeks and ≤30 weeks） to compare the mortalities, Results The major risks factors of premature birth in VLBWIs were multiple pregnancy （ 41.4 % ）, pregnancy complications （ 19. 5 % ）, premature-rupture of membrane （ 11.5 % ）, advanced age puerpera （4.4%） and unknown reasons（ 16.8% ）. All hospitalized VLBWIs had at least one complication. The incidences of complications were hypothermia （ 49. 6% ） , apnea （ 43, 4% ） , hypocalcemia （ 28. 3% ） , anemia of prematurity （ 28. 3% ） , pneumonia （26. 5% ）, hyperbilirubinemia （24. 8% ）, hyaline membrane disease （23 % ）, hyperglycemia （ 18.6% ）, and feeding intolerance （ 18. 6% ） etc, The overall survival rate was 73. 5% and the rate of death was 23. 9% in test group, The mortality rate of the infants with more than gestational weeks, was obviously lower than those with less than 30 weeks and the difference was significant （ P 〈 0. 05 ）, The mortality was reduced with the increase of weight （ P 〈 0, 05 ）, Conclusions Continuous and close postpartum careful monitoring should be performed in VLBWIs and the early finding and treatment of complications are very important for VLBWIs, so as to improve outcomes of VLBWIs,