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)