双胎早产儿的临床特点分析及神经精神发育水平相关研究

发布时间：2018-03-03 23:31

  本文选题：双胎早产儿　切入点：单胎早产儿　出处：《昆明医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的： 探讨双胎早产儿的临床特点,并在纠正胎龄1岁时进行神经精神发育的随访评估,了解双胎早产儿神经精神发育情况及分析其危险因素,并为今后的临床工作提供一定的指导。 方法： 1.收集2010年6月至2012年6月在我科新生儿病房住院的593例早产儿的临床资料包括胎龄、出生体重及并发症等,并将以上早产儿分为两组：其中131例双胎早产儿为研究组,462例单胎早产儿为对照组,对两组临床资料进行统计学分析。 2.对两组88例早产儿在纠正胎龄1岁时行神经精神发育随访,由我院儿童保健科专门人员采用湖南医科大学1995年主持修订的“贝利婴幼儿发展量表(Bay ley scales of infant development, BSID)"测试工具进行测试,其中研究组根据贝利婴幼儿发展量表正常测试结果分为神经精神发育异常组(Mental development index, MDI≤79分)和神经精神发育正常组(MDI79分),并对两组资料进行统计学分析。 结果： 1.两组临床资料比较：出生体重、胎膜早破、新生儿窒息、呼吸窘迫综合症(Respiratory distress syndrome, RDS)、呼吸暂停、胎粪吸入综合征(Meconium aspiration syndrome, MAS)、新生儿低血糖症、新生儿败血症及宫外生长发育迟缓差异有统计学意义。 2.研究组中大双与小双的新生儿败血症发病率差异有统计学意义。(P0.05)。 3.研究组MDI得分频数分布呈偏态分布,其中59%为神经精神发育异常(MDI≤79分)；但对照组MDI得分频数分布呈近似正态分布,其中仅12%为神经精神发育异常。 4.双胎早产儿头围、身长、体重、MDI、PDI均低于单胎早产儿,差异有统计学意义(P0.05)。 5.单因素分析中双胎早产儿神经精神发育异常(MDI≤79分)的高危因素有胎龄、出生体重、母亲育龄、父母亲文化程度、喂养方式、新生儿高胆红素血症、新生儿低血糖症、新生儿败血症、感染。 6.多因素Logistic回归分析显示新生儿高胆红素血症是双胎早产儿神经精神发育异常的独立危险因素。 结论： 1.双胎早产儿在新生儿期出现RDS、呼吸暂停、新生儿低血糖症、败血症及宫外生长发育迟缓的发病率较单胎早产儿高。但新生儿重度窒息、MAS的发病率则以单胎早产儿发生率较高。 2.同胎龄双胎早产儿的神经精神发育落后于单胎早产儿。 3.新生儿高胆红素血症是导致双胎早产儿神经精神发育异常的高危因素,故应早期积极处理新生儿高胆红素血症,有利于促进双胎早产儿的神经精神发育。
[Abstract]:Objective:. To investigate the clinical characteristics of twin premature infants and to evaluate the neuropsychiatric development at the corrected gestational age of 1 year, to understand the neuropsychiatric development of twin premature infants and to analyze its risk factors. And to provide certain guidance for the future clinical work. Methods:. 1. The clinical data of 593 premature infants hospitalized in our department from June 2010 to June 2012 were collected, including gestational age, birth weight and complications. The above premature infants were divided into two groups: 131 twin premature infants as the study group and 462 single premature infants as the control group. The clinical data of the two groups were analyzed statistically. 2. The neuropsychiatric development of 88 premature infants in two groups were followed up at the corrected gestational age of 1 year. Ley ley scales of infant development (BSIDD), which was revised by Hunan Medical University in 1995, was used to test children's health department in our hospital. According to the normal test results of Bailey Infant Development scale, the study group was divided into two groups: mental development index (MDI 鈮，

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