超低出生体质量早产儿病因及并发症分析

目的：分析超低出生体质量早产儿（ELBWI）相关的病因、并发症，以便更好地制定诊疗方案，改善患儿临床结局。方法：采用回顾性研究方法，选取我院NICU 1998年5月至2004年12月收治的ELBWI 32例（A组）和2012年1月至2014年6月收治的ELBWI 79例（B组），对相关早产原因、并发症进行比较分析。结果：B组中母亲行体外受精胚胎移植术（IVF-ET）、不良孕育史的患儿比例高于A组（P<0.05）。B组酸中毒、早产儿视网膜病变（ROP）、动脉导管未闭（PDA）、低血糖、休克、低体温、硬肿症的发生率较Ａ组下降，新生儿呼吸窘迫综合征（NRDS）、支气管肺发育不良（BPD）的发生率较A组升高（P均<0.05）。B组中，胎龄＜２８周的患儿NRDS、脑室周围白质软化（PVL）、呼吸暂停、BPD、院内感染、酸中毒、新生儿坏死性小肠结肠炎（NEC）的发生率高于胎龄≥28周的患儿（P均<0.05）。结论：ELBWI相关的早产原因和并发症较多，近年来的主要并发症为NRDS、呼吸暂停、BPD等。积极避免早产高危因素，制定正确的诊疗方案，防止严重并发症的发生，是改善ELBWI临床结局的关键。

Causes of Premature and Complications among Extremely Low Birth Weight

Objective: To analyse the causes of premature and complications among extremely low birth weight. In order to make better clinical decisions, improve clinical outcomes. Methods: To analyse the comparison of the data relating to the causes of premature and complications among 111 cases of birth weight of less than 1,000 g of extremely low birth weight, which from 1998 to 2004, 2012-2014. This data was retrospectively analysed. To comparise the causes of premature and complications between the 2 groups. At the same time, different gestational age of complications of 2012-2014 year were analyzed. Results: Two groups were compared: mother with IVF-ET technique and bad inoculation history leaded to higher incidence of premature than past, which was 22.78%. The incidence of RDS, BPD were higher than ever, which were 74.68%, 46.84% respectively. The smaller gestational age of children, the higher the incidence of RDS, PVL, apnea, and so on (P<0.05). Conclusion: There were many reasons about the causes of premature; RDS, apnea, BPD were the main complication of these premature babies in recent years.Actively avoiding a variety of risk factors of preterm labor, making the correct diagnosis and treatment plan for the extremely low birth weight premature infants, actively preventing the occurrence of serious complications, were the key to improve clinical outcomes.