中国实用儿科杂志

中国实用儿科杂志 ›› 2011, Vol. 26 ›› Issue (9): 682-.

• 论著 • 上一篇    下一篇

影响极低出生体重儿近期预后疾病及其析因分析

  

  1. 重庆医科大学附属儿童医院新生儿科，重庆　400014
  • 出版日期:2011-09-06 发布日期:2011-10-12

Diseases associated with the short-term outcome of very low birth weight infant and study of the causes.

  1. Department of Neonatology，Children’s Hospital of Chongqing Medical University，Chongqing 400014，China
  • Online:2011-09-06 Published:2011-10-12

摘要：

摘要：目的　探讨极低出生体重儿（VLBW）近期预后的疾病及其危险因素和保护因素。方法　总结重庆医科大学附属儿童医院2001年6月至2010年2月收治的475例符合纳入标准的VLBW患儿临床资料，找出对近期预后有显著影响的疾病。对这些疾病行单因素分析，将单因素分析中差异有统计学意义的变量代入logistic回归模型分析。结果　近期预后良好339例（71.37%）；近期预后不良136例（28.62%），两组中差异有统计学意义的疾病是新生儿呼吸窘迫综合征（NRDS）［11.8%（40例） vs 38.2%（52例），χ2 = 43.434，P = 0.000］、肺出血［2.9%（10例） vs 25.0%（34例），χ2 = 56.147，P = 0.000］。NRDS的危险因素为低出生体重（OR = 6.368，P = 0.000）、小于胎龄儿（OR = 5.806，P = 0.000）、有窒息史（OR = 2.087，P = 0.006）、产前未用地塞米松（OR = 1.948，P = 0.014）；NRDS的保护因素为胎膜早破（OR = 0.419，P = 0.004）。肺出血的危险因素为NRDS（OR = 10.473，P = 0.002）、硬肿（OR = 2.265，P = 0.027）；肺出血的保护因素为胎膜早破（OR = 0.167，P = 0.013）。结论　NRDS、肺出血是影响VLBW近期预后的重要疾病。

关键词: 极低出生体重儿, 近期预后, 新生儿呼吸窘迫综合征, 肺出血

Abstract:

Abstract：Objective　To investigate the causes of diseases associated with the short-term outcome of very low birth weight （VLBW） infant and their risk and protective factors. Methods　Review the critical diseases which can affect the short-term outcome of the total 475 cases in the Neonatology Department of Children`s Hospital of Chongqing Medical University from June 2001 to February 2010. Variables associated with these diseases were identified firstly with univariate analysis and then with a forward stepwise logistic regression. Results　The number of VLBW with favorable and poor short-term outcome was 339 （71.37%） and 136 （28.62%） respectively，and the following diseases were associated with the short-term outcome of VLBW： neonatal respiratory distress syndrome （NRDS）［11.8%（n = 40）vs 38.2%（n = 52），χ2 = 43.434，P = 0.000］ and pulmonary hemorrhage （PH）［2.9%（n = 10） vs 25%（n = 34），χ2 = 56.147，P = 0.000］.The risk factors for development of NRDS were low birth weight（OR = 6.368，P = 0.000）， being small for gestational age （SGA） （OR = 5.806，P = 0.000）， history of asphyxia （OR = 2.087，P = 0.006） and antepartum non-dexamethasone-treated （OR = 1.948，P = 0.014） .The protecting factor was history of premature rupture of membrane （PROM） （OR = 0.419，P = 0.004）.The risk factors for development of PH were NRDS （OR = 10.473，P = 0.002） and scleroma neonatorum（OR = 2.265，P = 0.027）；the protecting factor was PROM（OR = 0.167，P = 0.013）. Conclusion　Important diseases that can affect short-term outcome of VLBW are NRDS and PH.

Key words: very low birth weight （VLBW） infants, short-term outcome, neonatal respiratory distress syndrome（NRDS）, pulmonary hemorrhage （PH）