摘要
目的探讨极低和极早早产儿的临床资料及并发症发生情况,以及影响预后的因素。方法该组病例均选自该院自2013年4月—2014年5月收治的57例极低和极早早产儿的临床资料,将患儿分为三组：A组,19例,为胎龄小于32周,出生体重1 500 g以上;B组,19例,胎龄大于32周,出生体重小于1 500 g;C组,胎龄小于32周,出生体重小于1 500 g。全部患儿均给予校正年龄,并给予为期1年的观察随访,记录患儿一般情况及发育情况,记录0~1年内患儿体重、身长及头围情况,观察引起患儿生长发育迟缓的因素及患儿的临床表现。结果根据头围、身长及体重分别进行观察发现,C组患儿均明显高于A组与B组（P〈0.05）,但A组与B组比较,差异无统计学意义（P〉0.05）,C组患儿发生RDS、BPD及ROP比较,明显高于A及B组患儿,全部患儿中,出院时17例患儿表现为神经发育异常,在给予患儿矫正年龄6个月后观察发现,全部患儿出现神经发育异常征象的有11例,患儿多表现为上下肢肌张力偏高或偏低、原始反射持续时间延长、抬头困难等情况,给予早期干预后,3~4个月后神经发育异常征象均开始消失;1年后,仍有4例患儿存在神经发育异常征象。在对11例智力发育落后患儿进行持续跟踪随访正校正年龄18个月后,3例患儿确诊为脑瘫。观察发现,胎儿宫内生长发育受限（IUGR）、新生儿坏死性小结肠炎（NEC）及剖宫产在智力发育落后患儿中占比明显高于智力发育未受影响的患儿（P〈0.05）。对全部患儿进行矫正年龄,并给予为期1年的观察随访,全部患儿中,C组患儿中,1例出院后2个月死亡。结论极低且极早早产儿发生RDS、BPD及ROP比较,明显高于极低体重及极早早产儿,且生长发育也较其他二者迟缓。给予对症处理后,患儿神经发育异常症状可得到明显改善,分析认为,其与IUGR、NEC及剖宫产有一定关系。
Objective To investigate the clinical data and complications of very low and very early preterm infants, and to explore the factors influencing the prognosis. Methods In this group of patients are self institute since April 2013 to May2014 treated 57 cases of very low and very early preterm infants clinical data, the children were divided into three groups：group A, 19 cases, gestational age less than 32 weeks and birth weight 1 500 g above; group B, 19 cases, gestational age greater than 32 weeks, birth weight less than 1 500 g; group C, gestational age less than 32 weeks, birth weight less than 1500 g. All patients were given age correction, and give a period of 1 year of follow-up observation, record the general condition of the patient and the development, record of 0-1 years with body weight, length and head circumference of observed among children with growth retardation factors and children with clinical manifestations. Results According to the head circumference and body length and body weight were observed in C group were significantly higher than that in A group and B group（P〈0.05）, but the A group compared with B group, showed no significant difference（P〉0.05）, C group RDS, BPD and ROP, A and B groups were significantly higher than that of all children in the hospital 17 patients showed abnormal neurological development, observed in giving children 6 months corrected age, all patients had abnormal signs of neurological development in 11 cases, children showed higher or lower limb muscle tension, primitive reflex duration, lift head difficulties, early after the intervention, the signs of abnormal neural development after 3~4 months were beginning to disappear; 1 years later, there are still 4 cases of abnormal signs of neural development. In 11 children with mental retardation, 3 cases were diagnosed as cerebral palsy after being followed up for 18 months. Observation, it is found that fetal intrauterine growth retardation（IUGR）, neonatal necrotizing small colitis（NEC） and splits the palace production in mental retardation children accounted for is obviously higher than that in the intellectual development of unaffected children（P 〈 0.05）. All patients were corrected for age, and were given a 1 year follow-up, all the patients, C group, 2 patients died1 months after discharge. Conclusion The comparison of RDS, BPD and ROP in very low and very early preterm infants was significantly higher than that of very low birth weight and very early preterm infants, and the growth and development were also compared with those of the other two. After giving symptomatic treatment, children with abnormal neurological symptoms can be significantly improved, the analysis believes that it has a certain relationship with IUGR, NEC and cesarean section.
出处
《中国卫生产业》
2015年第31期52-54,共3页
China Health Industry
关键词
极低体重早产儿
极早早产儿
并发症
临床观察
影响因素
Very low birth weight premature infant
Very early premature infant
Complication
Clinical observation
Influencing factors
