目的 通过对12年来中心NICU中超低出生体重儿(extremely low birth weight infant,ELBWI)的生存状况分析,探讨ELBWI的生存质量及相关干预措施。方法 对本院新生儿病房NICU自2000年2月-2012年1月的32例ELBWI进行回顾性分析。结果 12年来ELBWI存活率34.4%,病死率25.0%,放弃率40.6%,辅助生育的ELBWI均积极治疗,存活率75.0%。所有存活者中女性占72.7%,明显高于男性。直接死亡原因最常见肺出血(62.5%),其次为早产儿肺透明膜病(12.5%)、颅内出血(12.5%)及消化道穿孔(12.5%)。将病例分为前、后两阶段(2000年2月-2006年1月和2006年2月-2012年1月)比较,后阶段放弃率明显低于前阶段(28.0%和85.7%),存活率明显高于前阶段(44%和0%);将病例分为存活组和死亡/放弃组比较,单因素及Logistic回归分析均显示辅助生育可能影响死亡率(P<0.05)。 结论 医患同盟积极救治,及时处理并发症,有助于提高ELBWI存活率,降低病死率;对处于生存极限的ELBWI的救治应权衡利弊,并注意提高ELBWI生活质量。

Objective To investigate the extremely low birth weight infant's (ELBWI) quality of life and related intervention measures through review of ELBWI's living condition from a single centre NICU in recently years. Method It was retrospectively analyzed about the clinical data of 32 patients of ELBWI from February 2000 to January 2012. Results The ELBWI suvival rate,mortality rate,abandon rate were 34.4%,25.0%,and 40.6%respectively.The Assisted Reproductive Technologies (ART) ELBWI suvival rate was 75.0%.Female suvival rate(72.7%) was higer than male's in all suvival patients.The common direct causes of death were pulmonary haemorrhage(62.5%),hyaline membrane disease (12.5%),intracranial haemorrhage(12.5%) and gastrointestinal bleeding(12.5%).The data were divided into two stages(February 2000~January 2006 vs February 2006~January 2012).Compared with the former group,the abandon rate of the later was obviously lower(28.0% vs 85.7%) and suvival rate was significantly higher (44% vs 0%).There was significant diffrence of ART between survival group and mortality/abandon group(P<0.05) with single factor analysis and logistic regression analysis. 【Conclutions】 Positive treatment and timely processing of complications can improve ELBWI survival rate and reduce mortality.The treatment of survival limits ELBWI should weigh up pros and cons,and should elevated the living quality of ELBWI.