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523例住院早产儿临床特点分析

Clinical Features of 523 Hospitalized Preterm Infants

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目的 分析本院新生儿重症监护室(NICU)近3年住院早产儿的临床资料,掌握住院早产儿的临床特点.方法 选取2020年1月至2023年6月收治于内蒙古自治区人民医院NICU的523例早产儿作为研究对象,依据胎龄将其分为超早产儿组(胎龄<28周组)、极早产儿组(胎龄28~31+6周组)及中晚期早产儿组(胎龄32~36+6周组),采用回顾性分析方法,比较3组早产儿的临床资料及住院期间并发症发生情况.结果 (1)收治的523例早产儿中以胎龄32~36+6周为主(73.6%,385/523);(2)总体发病率较高的前三种疾病分别为:新生儿黄疸(91.0%,476/523)、早产儿脑损伤(50.5%,264/523)、呼吸窘迫综合征(NRDS)(28.7%,150/523);(3)胎龄<28 周组以 NRDS(100.0%,30/30)、新生儿黄疸(90.0%,27/30)、早产儿脑损伤(90.0%,27/30)等疾病多发,28~31+6周组排名前三位的疾病依次为:新生儿黄疸(88.9%,96/108)、早产儿脑损伤(71.3%,77/108)、NRDS(68.5%,74/108),32~36+6周早产儿发病率较高的前三种疾病依次为:新生儿黄疸(91.7%,353/385)、早产儿脑损伤(41.6%,160/385)及暂时性甲状腺功能异常(25.2%,97/385);(4)神经、呼吸、循环、消化及血液系统中发病率最高的疾病分别为:早产儿脑损伤(50.5%,x2=49.723,P<0.001)、NRDS(28.7%,x2=211.093,P<0.001)、PDA(25.2%,x2=84.812,P<0.001)、早产儿喂养不耐受(14.9%,x2=33.804,P<0.001)、贫血(24.3%,x2=54.074,P<0.001),各疾病在 3 组间发病率随胎龄的增加而降低,且差异均具有统计学意义;(5)523例住院活产早产儿中死亡2例(0.4%),自动出院或放弃救治19例(3.6%),治愈或好转出院502例(96.0%),救治率接近全国平均水平.结论 不同胎龄组早产儿各系统疾病并发情况不同,同一疾病不同胎龄组早产儿发病率不同,胎龄越小发病率越高;针对不同胎龄患儿发病率较高的疾病进行预防、诊断和治疗,是降低早产儿发病率、病死率和提高治愈率的关键.
Objective To analyze the clinical characteristics of preterm infants hospitalized in Neonatal In-tensive Care Unit(NIUC)of our hospital in recent 3 years,and to grasp the clinical characteristics of hospital-ized premature infants.Methods A total of 523 premature infants hospitalized in the NICU of Inner Mongolia Autonomous Region People's Hospital between January 2020 and June 2023 were selected as the research sub-jects,and they were divided into extremely preterm infants(gestational age<28 weeks)、very preterm infants(gestational age 28~31+6 weeks)and middle-late preterm infants(gestational age 32~36+6 weeks)according to gestational age,then the retrospective analysis method was used to compare the clinical data and the occur-rence of complications during hospitalization of the three groups of preterm infants.Results(1)Among the 523 premature infants admitted,the gestational age was mainly 32~36+6 weeks(73.6%,385/523);(2)The first three disorders with a higher incidence in preterm infants in this data were:neonatal jaundice(91.0%,476/523),preterm brain injury(50.5%,264/523)and NRDS(28.7%,150/523);(3)Thegestational age<28 weeks group had more common diseases such as NRDS(100.0%,30/30)、neonatal jaundice(90.0%,27/30)and preterm brain injury(90.0%,27/30),the top three diseases in 28~31+6 weeks group were neonatal jaundice(88.9%,96/108)、preterm brain injury(71.3%,77/108)、NRDS(68.5%,74/108),the top three diseases with the highest incidence at 32~36+6 weeks were:neonatal jaundice(91.7%,353/285)、preterm brain injury(41.6%,160/385)and temporary thyroid dysfunction(25.2%,97/385);(4)The diseases with the highest in-cidence in the nervous、respiratory、circulatory、digestive and hematologic system were:preterm brain injury(50.5%,x2=49.723,P<0.001)、NRDS(28.7%,x2=211.093,P<0.001)、PDA(25.2%,x2=84.812,P<0.001)、feeding intolerance(14.9%,x2=33.804,P<0.001)、anemia(24.3%,x2=54.074,P<0.001),the incidence of each disease among the three groups decreased with the increase of gestational age,and the differences were statistically significant;(5)Among the 523 hospitalized live births of preterm infants,2 cases(0.4%)were died,19 cases(3.6%)were voluntarily discharged or gave up,and 502 cases(96.0%)were cured or discharged,and the treatment rate was closed to the national average.Conclusions The incidence of diseases in different gestational age groups was different,and the incidence of premature infants in different gestational age groups of the same disease was also different,the smaller the gestational age,the higher the inci-dence;targeted prevention,timely diagnosis and treatment of diseases is the key to reduce the morbidity and mortality in preterm infants to improve their cure rate.

premature infantscomplicationsclinical features

庞梦华、张鑫、张晓梅

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内蒙古科技大学包头医学院,内蒙古包头 014040

内蒙古医科大学,呼和浩特 010110

内蒙古自治区人民医院新生儿科,呼和浩特 010017

早产儿 疾病谱 临床特点

2024

内蒙古医学杂志
内蒙古自治区医学会

内蒙古医学杂志

影响因子:0.537
ISSN:1004-0951
年,卷(期):2024.56(3)