晚期早产儿中小于胎龄儿的临床分析

发布时间：2018-03-23 23:08

本文选题：晚期早产儿　切入点：小于胎龄儿　出处：《昆明医科大学》2017年硕士论文

【摘要】：[目的]本研究通过分析晚期早产儿中小于胎龄儿的出生一般情况、孕母危险因素及生后患病情况,旨在为临床干预及管理晚期早产儿中的小于胎龄儿,提供理论依据。[方法]收集昆明医科大学第二附属医院儿科新生儿室2015年1月至2016年12月共1023例住院新生儿病历资料。依据胎龄与出生体重的关系将收集的新生儿分为三组,分别为晚期早产儿中小于胎龄儿组,晚期早产儿中适于胎龄儿组及足月儿中小于胎龄儿组。分别比较晚期早产儿中小于胎龄儿与适于胎龄儿,晚期早产儿中小于胎龄儿与足月儿中小于胎龄儿的出生一般情况、孕母危险因素及生后患病情况。[结果]1.晚期早产儿中小于胎龄儿较晚期早产儿中适于胎龄儿,出生体重低(1763±161g比2463±282g),剖宫产率高(86.7%比59.9%),需呼吸机支持的比例高(15%比8.3%),住院时间长(13.1±1.6d比10.3±1.5d) (P均0.05)。晚期早产儿中小于胎龄儿较足月儿中小于胎龄儿,出生体重低( 1763±161g比2296±301g),剖宫产率高(86.7%比 37%) (P 均0.05)。2.晚期早产儿中小于胎龄儿较晚期早产儿中适于胎龄儿,其孕母孕期发生妊娠期高血压、多胎妊娠、胎儿宫内窘迫的比例更高(分别为35.2%比13.5%, 20.8%比13.4%, 13.9%比3.9%) (P均0.05)。晚期早产儿中小于胎龄儿较足月儿中小于胎龄儿,其孕母孕期发生妊娠期高血压、妊娠期糖尿病、胎盘或脐带异常、胎儿宫内窘迫的比例更高(分别为35.2%比8.9%,6.4%比1.4%,15%比6.4%,13.3%比 4.3%, 13.9%比 3.2%) (P 均0.05)。3.晚期早产儿中小于胎龄儿较晚期早产儿中适于胎龄儿,生后发生新生儿窒息、低血糖症、贫血的比例更高(分别为12.1%比7.4%,30.6%比21.9%,50.9%比37.9%) (P均0.05)。晚期早产儿中小于胎龄儿较足月儿中小于胎龄儿,生后发生电解质紊乱、贫血、消化道出血、呼吸暂停的比例更高(分别为65.9%比29.5%,50.9%比 37.7%,6.9%比 2.5%,8.1%比 3.2%) (P 均0.05)。[结论]1.晚期早产儿中小于胎龄儿较晚期早产儿中适于胎龄儿及足月儿中小于胎龄儿均更易发生生后并发症,其中新生儿窒息、低血糖症的发生可能与其小于胎龄有关;而电解质紊乱、贫血、消化道出血、呼吸暂停的发生可能与其晚期早产有关。2.患有妊娠期高血压疾病或发生胎儿宫内窘迫的孕母,更易分娩出晚期早产儿中小于胎龄儿。3.晚期早产儿中小于胎龄儿的发生,与孕母的病理生理状态有关,应加强孕母危险因素的监测及晚期早产儿中小于胎龄儿生后并发症的早期防治,改善其近期及远期结局。
[Abstract]:[objective] by analyzing the general conditions of birth, maternal risk factors and postnatal morbidity in late preterm infants, the purpose of this study was to provide clinical intervention and management of small gestational age infants in late preterm infants. [methods] to collect the medical records of 1023 hospitalized newborns in the Department of Pediatrics newborns, second affiliated Hospital of Kunming Medical University from January 2015 to December 2016. According to the relationship between gestational age and birth weight, the collected newborns were divided into three groups. They were small gestational age group of late premature infants, suitable gestational age group of late premature infants and small gestational age group of term infants. The general conditions of birth, maternal risk factors and postnatal morbidity in late premature infants with less than gestational age and term infants. [results] 1. In late preterm infants, the smaller premature infants are more suitable for gestational age than those in late preterm infants. The lower birth weight was 1763 卤161g vs 2463 卤282g / g, the rate of cesarean section was 86.7% vs 59.9g / g, the proportion requiring ventilator support was 15% higher than 8.3%, and the length of hospitalization was 13.1 卤1.6d vs 10.3 卤1.5drespectively. The birth weight was low (1763 卤161g vs 2296 卤301g / g, and the cesarean section rate was 86.7% vs 37g). The proportion of fetal distress was higher (35.2% vs 13.5%, 20.8% vs 13.4%, 13.9% vs 3.9%). Abnormal placenta or umbilical cord, the proportion of fetal distress was higher (35.2% vs 8.9% vs 1.4% vs 1.4% vs 6.4% vs 4.3%, 13.9% vs 3.2%). Hypoglycemia and anemia were higher (12.1% vs 7.4% vs 30.6% vs 21.9% vs 50.9% vs 37.9%). The proportion of apnea was higher (65.9% vs 29.5g% vs 37.7% vs 6.9% vs 2.5.1% vs 3.2cm). [conclusion] 1.The late premature infants with small gestational age were more likely to have postnatal complications than those with moderate gestational age and full-term infants. Among them, neonatal asphyxia, hypoglycemia may be related to their smaller gestational age, while electrolyte disorders, anemia, gastrointestinal bleeding, The occurrence of apnea may be related to late preterm delivery. 2. Pregnant mothers with hypertensive disorder complicating pregnancy or fetal distress are more likely to give birth to late premature infants smaller than gestational age. It is necessary to strengthen the monitoring of maternal risk factors and the early prevention and treatment of complications in late preterm infants smaller than the gestational age in order to improve the short-term and long-term outcomes.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.6

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