长沙市住院早产儿流行病学调查

发布时间：2018-05-05 16:48

本文选题：早产儿 + 长沙市　；参考：《中南大学》2009年硕士论文

【摘要】： 目的通过对长沙市较大范围的住院早产儿流行病学调查,提供有关长沙市住院早产儿的资料,旨在揭示长沙市住院早产儿发生的主要病因、新生儿期疾病分布情况及影响其转归的因素,为降低早产儿的发生率及改善其生存质量提供理论依据。方法 1.对中南大学湘雅二医院、湖南省妇幼保健院、浏阳市妇幼保健院三家医院2008年1月～12月一年内新生儿科全部住院早产儿的资料进行调查。主要内容为:①产妇方面包括:母亲年龄、母亲疾病史、母孕史,孕妇有无妊娠期高血压、妊娠期糖尿病、羊膜早破、胎盘早剥、前置胎盘等;②新生儿方面包括各种生理参数、有无宫内窘迫、窒息、新生儿期疾病及生后28天结局等。 2.统计学方法:应用SPSS16.0统计软件包,计数资料用百分率表示,胎龄/出生体重用均数±标准差表示,分析新生儿期疾病分布规律用χ~2检验(样本量小时用Fisher's确切检验)及相关分析,影响生后28天结局的相关危险因素采用Logistic回归分析(P＜0.05认为有统计学意义)。结果 1.2008年新生儿科共住院早产儿961例,男女比为1.26:1。按胎龄分为3组:≤28周组(1.1%),胎龄(27.33±0.91)周:28～32周组(15.8%),胎龄(30.87±1.10)周,＞32周组(83.1%),胎龄(35.07±1.24)周。按出生体重分为4组:＜1000g组(0.7%),体重(886.43±57.64)g,＜1500g组(11.1%),体重(1294.16±131.63)g,＜2500g组(61.3%),体重(2061.04±260.57)g,≥2500g组(26.9%),体重(2816.59±312.61)g。 2.早产的主要病因依次为胎膜早破(41.6%)、多胎妊娠(28.9%)、妊娠期高血压(16.6%)、母孕期感染(13.1%)、前置胎盘(6.8%)、妊娠期糖尿病(5.8%)、贫血(5.5%)、妊娠期胆汁淤积症(4.7%)、肝炎(2.9%),胎盘早剥(2.4%)等。 3.早产儿在新生儿期疾病发生率依次为呼吸系统疾病(73.8%)、新生儿感染(败血症)(39.4%)、神经系统疾病(38.3%)、代谢性酸中毒(28.9%)、高胆红素血症(22.9%)、消化系统疾病(21.7%)和血液系统疾病(20%)等。 4.随着胎龄、体重的增加,早产儿在新生儿期疾病的总体发生率有下降趋势。随着胎龄、出生体重增加,除循环系统疾病的发生率各组间差异无统计学意义(P＞0.05)外,其他疾病的发生率及生后28天治愈好转率各组间差异有统计学意义(P＜0.05)。 5.新生儿肺炎、新生儿呼吸窘迫综合征、呼吸暂停、肺出血、新生儿感染(败血症)、颅内出血、早产儿脑损伤、喂养不耐受、高胆红素血症、新生儿窒息、代谢性酸中毒、糖代谢紊乱、新生儿硬肿症与胎龄均呈负相关(P＜0.05);新生儿肺炎、新生儿呼吸窘迫综合征、呼吸暂停、肺出血、新生儿感染(败血症)、颅内出血、早产儿脑损伤、喂养不耐受、新生儿窒息、代谢性酸中毒、糖代谢紊乱、新生儿硬肿症与出生体重均呈负相关(P＜0.05);早产儿生后28天治愈好转率与胎龄、出生体重呈正相关(P＜0.05)。 6.胎龄增加、出生体重增长是影响早产儿生后28天结局的保护因子;新生儿窒息、高胆红素血症、新生儿硬肿症、糖代谢紊乱、新生儿感染(败血症)、颅内出血是影响早产儿生后28天结局的危险因素。结论 1.引起早产的主要病因依次为胎膜早破、多胎妊娠、妊娠期高血压等。 2.早产儿最常见新生儿期疾病依次为呼吸系统疾病、新生儿感染(败血症)、神经系统疾病等;随着胎龄、出生体重的增加,多数疾病的发生率有下降趋势,生后28天治愈好转率呈上升趋势。 3.胎龄增加、出生体重增长是影响早产儿生后28天结局的保护因子;新生儿窒息、高胆红素血症、新生儿硬肿症、新生儿感染(败血症)、颅内出血是影响早产儿生后28天结局的危险因素。
[Abstract]:objective
Through the epidemiological survey on the large range of hospitalized preterm infants in Changsha, the information about the preterm infants in Changsha was provided to reveal the main causes of the premature infants in the hospital in Changsha, the distribution of the diseases in the newborns and the factors affecting their outcome, so as to provide a theoretical basis for reducing the incidence of premature infants and improving their quality of life. According to it.
Method
1. to investigate the data of all the premature infants in the new Department of Pediatrics in three hospitals of Xiangya No.2 Hospital, Hunan maternity and child health care hospital and Liuyang maternal and child health care hospital from January 2008 to December. The main contents are: (1) maternal age, mother's disease history, mother pregnancy history, pregnant women without pregnancy hypertension, pregnancy sugar Urinary disease, premature rupture of amniotic membrane, placenta abruption, placenta previa, etc.; 2. Neonatal aspects include various physiological parameters, such as intrauterine distress, asphyxia, neonatal disease and the 28 day outcome after birth.
2. statistical method: using the SPSS16.0 statistical software package, the count data were expressed as a percentage, the gestational age / birth weight was expressed as a standard deviation, and the distribution of the diseases in the newborn period was analyzed by the chi square ~2 test (the exact test of Fisher's in the sample size) and the correlation analysis, and the related risk factors affecting the outcome of the 28 days after birth were used in the regression analysis. Analysis (P < 0.05).
Result
1.2008 years of newborn children were hospitalized with 961 preterm infants. The ratio of male and female to 1.26:1. was divided into 3 groups: 28 weeks (1.1%), fetal age (27.33 + 0.91) weeks, 28~32 weeks (15.8%), gestational age (30.87 + 1.10) weeks, 32 weeks (83.1%), and gestational age (3). Body weight (1294.16 + 131.63) g, group 2500g (61.3%), body weight (2061.04 + 260.57) g, group 2500g (26.9%), body weight (2816.59 + 312.61) g.
2. the main causes of premature birth were premature rupture of membranes (41.6%), multiple pregnancy (28.9%), pregnancy induced hypertension (16.6%), maternal infection (13.1%), placenta previa (6.8%), gestational diabetes (5.8%), anemia (5.5%), pregnancy cholestasis (4.7%), hepatitis (2.9%), and placental abruption (2.4%).
3. the incidence of premature infants in the neonatal period was respiratory disease (73.8%), neonatal infection (sepsis) (39.4%), nervous system disease (38.3%), metabolic acidosis (28.9%), hyperbilirubinemia (22.9%), digestive system disease (21.7%) and blood system disease (20%).
4. as the gestational age and weight increase, the overall incidence of the premature infants in the neonatal period has a downward trend. With the gestational age and the increase of birth weight, there is no statistical significance (P > 0.05), the incidence of other diseases and the recovery rate of 28 days after birth (P < 0). .05).
5. neonatal pneumonia, neonatal respiratory distress syndrome, respiratory apnea, pulmonary hemorrhage, neonatal infection (sepsis), intracranial hemorrhage, brain injury in premature infants, feeding intolerance, hyperbilirubinemia, neonatal asphyxia, metabolic acidosis, glucose metabolism disorder, neonatal sclerosis and gestational age (P < 0.05); neonatal pneumonia, neonatal call Respiratory distress syndrome, apnea, pulmonary hemorrhage, neonatal infection (sepsis), intracranial hemorrhage, brain injury in premature infants, feeding intolerance, neonatal asphyxia, metabolic acidosis, glucose metabolism disorder, neonatal sclerosis and birth weight were negatively correlated (P < 0.05), and the recovery rate of 28 days after birth was positively correlated with gestational age and birth weight (P < 0.05).
The increase of 6. gestational ages and the growth of birth weight are protective factors affecting the outcome of the 28 day postnatal birth. Neonatal asphyxia, hyperbilirubinemia, neonatal sclerosis, glucose metabolism disorder, neonatal infection (sepsis), intracranial hemorrhage are the risk factors that affect the 28 day outcome of the birth of premature infants.
conclusion
1. the main causes of premature birth are premature rupture of membranes, multiple pregnancy, gestational hypertension and so on.
2. the most common neonatal diseases in preterm infants are respiratory diseases, neonatal infection (sepsis), nervous system diseases, and so on. With the increase of fetal age and birth weight, the incidence of most diseases has a downward trend, and the recovery rate of the 28 days after birth is on the rise.
The increase of 3. gestational ages and the growth of birth weight are protective factors affecting the outcome of the 28 day postnatal birth. Neonatal asphyxia, hyperbilirubinemia, neonatal sclerosis, neonatal infection (sepsis), intracranial hemorrhage are the risk factors affecting the 28 day outcome of the birth of preterm infants.

【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R722.6;R181.3

【参考文献】