目的 分析河南省早产儿的并发症及其结局,为改善早产儿不良预后提供依据。方法 回顾性分析2019年1月1日—12月31日河南省17地市53家医院产科分娩的共计12 406例活产早产儿的并发症及结局的情况。 结果 1)并发症:发生率依次为肺炎(39.3%)、呼吸窘迫综合征(34.7%)、窒息(17.0%)、动脉导管未闭(13.5%)、败血症(5.6%)、脑室内出血(5.5%)、坏死性小肠结肠炎(2.2%)、支气管肺发育不良(1.7%)、脑室周围白质软化(1.6%)、早产儿视网膜病(1.2%)等,除气胸外,不同胎龄早产儿并发症发生率比较,差异有统计学意义(P＜0.01);除胆汁淤积症、颅内感染、新生儿持续性肺动脉高压外,不同级别医院早产儿并发症发生率比较,差异有统计学意义(P＜0.01);2)治疗结局:好转、放弃、死亡及转院发生率分别为93.4%、2.6%、0.8%、3.2%;除死亡率外,不同级别医院早产儿治疗结局比较,差异有统计学意义(P＜0.01);3)早产儿死亡主要发生在生后1周内(占比63.2%);主要死亡原因为感染性疾病、呼吸窘迫综合征、窒息、先天畸形、肺出血等。结论 早产儿并发症主要包括肺炎、呼吸窘迫综合征、窒息、动脉导管未闭、败血症、脑室内出血等,出生胎龄与早产儿并发症及结局密切相关。因此,有必要进一步完善各级救治网络,加强产前筛查及围生期保健,积极防治并发症,改善早产儿预后。
Abstract
Objective To investigate the complications and consequences of preterm infants in Henan province, so as to provide basis for improving the poor prognosis of preterm infants. Methods A total of 12 406 live premature infants from 53 hospitals in 17 cities of Henan province, born from January 1st, 2019 to December 31st, 2019, were selected into this study, and their complications and consequences were retrospectively collected and analyzed. Results 1) The most common complication was pneumonia(39.3%), followed by respiratory distress syndrome (34.7%), asphyxia (17.0%), patent ductus arteriosus (13.5%), septicemia (5.6%), intraventricular hemorrhage (5.5%), necrotizing enterocolitis (2.2%), bronchial pulmonary dysplasia (1.7%), periventricular leukomalacia (1.6%), retinopathy of prematurity (1.2%).And the incidence of the above complications except pneumothorax of premature infants was statistically significant among different gestational age groups (P＜0.05).The complication incidence of premature infants in different grades of hospitals was statistically significant (P＜0.05) except the incidence of cholestasis, intracranial infections and persistent pulmonary hypertension of the newborn.2) In terms of treatment outcome, the incidence rates of improvement, abandonment, death and transferring to another hospital of premature infants were 93.4%, 2.6%, 0.8% and 3.2%.The treatment consequences except death rate of premature infants differed significantly in different grades of hospitals(P＜0.01).3) Premature infants most (63.2%) died within 1 week of birth, and the main causes included infectious diseases, respiratory distress syndrome, asphyxia, congenital malformations and pulmonary hemorrhage. Conclusions The complications of premature infants mainly include pneumonia, respiratory distress syndrome, asphyxia, patent ductus arteriosus, septicemia and intraventricular hemorrhage.Gestational age is closely related to the complications and consequences of premature infants.Therefore, it is necessary to further improve the treatment network of all grades, to strengthen prenatal screening and perinatal health care, and to prevent and cure complications positively, thereby improving the prognosis of premature infant.
关键词
并发症 /
结局 /
死亡原因 /
早产儿
Key words
complications /
consequences /
cause of death /
premature infants
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参考文献
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