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目的 探讨影响极低出生体重儿 (verylowbirthweightinfant,VLBWI)存活率的相关因素 ,为降低其病死率和病残率提供依据。 方法 对 1993年 1月～ 1998年 1月收治的 116例VLBWI按体重分三组 ,对其临床资料进行回顾性分析。 结果 VLBWI治愈出院 86例 ,治愈率74 .1% (86 116 ) ;随体重增加而上升 (P <0 .0 5 ) ;治愈者平均住院 (2 7± 13)d ,住院天数随体重增加而缩短 (P <0 .0 5 ) ;病死 15例 ,病死率 12 .9% (15 116 ) ;病死率随体重增加而降低 (P <0 .0 1)。导致VLBWI的主要原因有多胎妊娠 (2 6 .7% ) ,胎膜早破 (2 1.4 % ) ,妊娠并发症 (12 .6 % ) ,习惯性早产(3.1% ) ,妊娠期患内科慢性疾病 (1.3% )和原因不明 (34.9% )。所有住院患儿均有一种以上并发症 ,≤ 10 0 0 g的超低出生体重儿的发生率高达83.3% ,其体重越低 ,并发症的发生率越高 (P <0 .0 1)。存活率 87.1% ,体重≤ 10 0 0 g存活率为 5 6 .3%。死亡的主要原因是肺出血、呼吸窘迫综合征、感染和颅内出血。 结论 提高VLBWI近远期存活率 ,除重视围产期及儿科的处理外 ,VLBWI必须早期发现 ,密切监护 ,及时处理并发症。
Objective To investigate the related factors that affect the survival rate of very low birth weight infants (VLBWI) and provide the basis for reducing their mortality and morbidity. Methods 116 cases of VLBWI admitted from January 1993 to January 1998 were divided into three groups according to body weight, and their clinical data were retrospectively analyzed. Results The cure rate was 74.1% (86 116) in VLBWI patients, and the cure rate increased with weight gain (P <0.05). The average hospitalization rate of cured patients was (2 7 ± 13) d. The hospitalization days increased with body weight (P0.05), 15 cases died and the case fatality rate was 12.9% (15 116). The case fatality rate decreased with weight gain (P0.01). The main causes of VLBWI were multiple pregnancy (26.7%), premature rupture of membranes (21.4%), complications of pregnancy (12.6%), habitual premature labor (3.1%), chronic diseases of internal medicine during pregnancy (1.3%) and unknown cause (34.9%). All hospitalized children had more than one complication. The incidence of ultra-low birth weight infants weighing up to 100 g was as high as 83.3%. The lower the body weight, the higher the incidence of complications (P <0.01). Survival rate of 87.1%, body weight ≤ 10 0 g survival rate of 56.3%. The main causes of death are pulmonary hemorrhage, respiratory distress syndrome, infection and intracranial hemorrhage. Conclusion To improve the short-term and long-term survival rate of VLBWI, VLBWI must be detected early and monitored intensively in order to treat complications in a timely manner, besides paying attention to perinatal and pediatric treatment.