98例早产儿死亡原因分析

目的 分析安徽省立医院新生儿科近4年住院早产儿死亡原因,为降低早产儿病死率提供防治措施。 方法 通过收集安徽省立医院2013年1月1日-2016年12月31日新生儿科98例死亡早产儿的性别、出生方式、出生胎龄、出生体重、死因等资料进行回顾性分析。 结果 ①近4年住院早产儿共2 794例,死亡98例,总病死率为3.51%(98/2 794);各年病死率分别为2013年4.36%(25/573)、2014年3.79%(24/633)、2015年3.48%(23/660)、2016年2.80%(26/928);早产儿总数呈渐增趋势,病死率总体呈下降趋势,但各年间病死率差异无统计学意义。②不同胎龄间死亡早产儿病死率比较,差异有统计学意义(P<0.05);不同体重间病死率比较,差异有统计学意义(P<0.05);早产儿出生胎龄越小、体重越低,病死率越高。③早产儿主要死因顺位前5位为肺透明膜病27.55%(27/98)、感染性疾病20.41%(20/98)、窒息14.29%(14/98)、先天性出生缺陷11.22%(11/98)、肺出血9.18%(9/98)。 结论 该院早产儿死亡主要原因与早产儿胎龄、体重以及肺透明膜病、感染性疾病、窒息、先天性出生缺陷、肺出血等并发症有密切关系;可通过加强产前筛查和围生期保健、提高早产儿窒息复苏抢救水平、加强早产儿呼吸道管理和感染的防控,从而降低早产儿病死率。 

Analysis of the causes of death in 98 preterm infants

Objective To explore the causes of death of the neonatal nearly 4 years hospitalized premature infants in the Anhui Provincial Hospital,ensure effective measures to reduce the mortality of premature infants. Methods Through the collection of Anhui Provincial Hospital from January 1, 2013 to December 31, 2016 of 98 neonatal death cases of preterm infants (male, female) sex, birth (birth, cesarean section), gestational age (<28 weeks, 28-31+6 weeks, 32-33+6 weeks, 34-36+6 weeks), birth weight (<1 000 g, 1 000-1 499 g, 1 500-1 999 g, 2 000-2 499 g, 2 500 g, etc.), the cause of death were retrospectively analyzed. Results ① nearly 4 years a total of 2 794 cases of hospitalized premature infants, 98 cases died, the total Mortality rate was 3.51% (98/2 794); the annual mortality rate in each year was 4.36% (in 2013, 25/573), 3.79% (in 2014, 24/633), 3.48%(in 2015, 23/660), 2.80% (in 2016, 26/928); the total number of preterm infants has increased, the mortality rate was decreasing the trend, but each year the mortality rate difference. ② the mortality rate of premature infants with different gestational age was statistically significant (P<0.05). There was a significant difference in mortality between different body weight (P<0.05). The smaller the gestational age, the lower the body weight and the higher the fatality rate. ③ the leading causes of death in preterm infants were lung hyaline membrane disease 27.55% (27/98), infectious diseases 20.41% (20/98), asphyxia 14.29% (14/98), congenital birth defects 11.22% (11/98), and pulmonary hemorrhage 9.18% (9/98). Conclusion The main causes of premature death in preterm infants with gestational age, body weight, and there is a close relationship between hyaline membrane disease, infectious disease, asphyxia, congenital birth defects, pulmonary hemorrhage and other complications; through strengthen prenatal screening and prevention of perinatal health care, improve the premature infant resuscitation rescue level, strengthen the management of respiratory tract infection and preterm infants in order to reduce the mortality of premature babies.