极低出生体重儿的临床救治及转归

发布时间：2018-07-30 06:30

【摘要】：研究目的：回顾性分析极低出生体重儿(VLBWI)发生原因、合并症、临床救治方法及其转归,了解目前VLBWI的救治现状,提高救治水平及生存质量。研究对象及方法：选用山东省立医院新生儿科在2011年1月至2012年7月收治的极低出生体重儿160例为研究对象,依照生后体重分为1000g-1200g、12011500g,按胎龄分为28w-30w、30w-32w两组,采取调查表回顾性分析对其发生原因、常见并发症、治疗措施、转归进行统计分析。结果：160例研究对象中VLBWI合并症以NRDS、肺炎为主,发生率分别为71.9%、57.5%；治疗措施中接受吸氧治疗占81.3%,平均用氧时间为(7.0±11.6)d,接受肺表面活性物质(PS)替代治疗占69.4%；接受CPAP治疗占43.1%,行呼吸机治疗占18.1%,接受静脉营养占81.3%,静脉营养的时间平均为(6.7±1.9)d,平均成功开奶日龄为(7.5±4.1)d,使用血管活性药物如多巴胺、多巴酚丁胺等占52.5%。转归情况：160例患儿治愈率91.2%,放弃率为4.4%,死亡率为4.4%。结论：1.RDS是影响VLBWI存活率的首要并发症,本资料发生率高达71.9%,其它的合并症依次为肺炎、贫血、败血症、低血糖、ROP。 2.救治措施中,肺表面活性物质的应用是抢救VLBWI成功的关键,本资料69.4%患儿均接受PS治疗。 3.ROP是VLBWI的重要合并症之一,本组发生率为16.9%,提示常规筛查十分必要,可避免失明的发生。 4.孕母自身疾病是影响VLBWI发生率的危险因素,依次为妊娠高血压综合征、胎膜早破、妊娠期糖尿病。
[Abstract]:Objective: to retrospectively analyze the causes, complications, clinical treatment methods and outcome of (VLBWI) in very low birth weight infants, to understand the current treatment status of VLBWI, and to improve the treatment level and quality of life. Subjects and methods: 160 cases of very low birth weight infants admitted to the Department of Neonatrics in Shandong Provincial Hospital from January 2011 to July 2012 were divided into two groups according to their postnatal weight: 1000g-1200g / 12011500g and 28w-30w / 30w-32w, respectively. The causes, common complications, treatment measures and outcome were analyzed retrospectively by questionnaire. Results the main complications of VLBWI were NRDS and pneumonia, the incidence rates were 71.9% and 57.5% respectively, 81.3% of them were treated with oxygen inhalation, the average time of using oxygen was (7.0 卤11.6) days, and that of pulmonary surfactant (PS) replacement therapy was 69.4%. The average time of intravenous nutrition was (6.7 卤1.9) days, the mean age of successful lactation was (7.5 卤4.1) days, the use of vasoactive drugs such as dopamine, dobutamine and so on accounted for 52.5 minutes. The cure rate was 91.2%, the abandonment rate was 4.4%, and the mortality rate was 4.4%. ConclusionRDS is the primary complication affecting the survival rate of VLBWI. The incidence of this data is as high as 71.9. The other complications are pneumonia, anemia, septicemia, hypoglycemia and ROP. 2. In the treatment measures, the application of pulmonary surfactant is the key to the successful rescue of VLBWI. 69.4% of the children received PS therapy. 3.ROP is one of the important complications of VLBWI, the incidence rate of this group is 16.9g, suggesting that routine screening is very necessary. To avoid blindness. 4. Maternal disease is a risk factor affecting the incidence of VLBWI, followed by pregnancy hypertension syndromes, premature rupture of membranes, gestational diabetes mellitus.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R722.1

【参考文献】