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目的探讨区域内胎龄≤33周早产儿不同转运模式与并发症及死亡率的关系。方法回顾性分析2010~2012年收入胎龄≤33周早产儿805例,按照不同的转运模式分为胎儿宫内转运组209例、新生儿转运组211例和本院分娩组385例。比较3组母亲高危因素、早产儿早晚期并发症和预后情况。结果新生儿转运组胎膜早破、妊娠期高血压疾病、临床羊膜炎、产前抗生素使用率、产前24小时激素使用率和医源性早产发生率低于其他两组,自发性早产发生率最高;宫内转运组和本院分娩组胎膜早破发生率、产前抗生素使用率和临床羊膜炎发生率较高;新生儿转运组入院体温低,危重新生儿评分高和窒息发生率高,1分钟及5分钟Apgar评分低;宫内转运组特发性呼吸窘迫综合征发生率低,重症肺炎发生率高,出生体重低,极低体重儿多,晚发性败血症发生率高。结论早产儿宫内转运至具备新生儿重症监护的产科中心,减少窒息、特发性呼吸窘迫综合征和低体温的发生率,不降低早产儿死亡率。
Objective To explore the relationship between different transport modes and complications and mortality in preterm infants of gestational age ≤33 weeks. Methods A retrospective analysis of 805 preterm infants with gestational age ≤33 weeks from 2010 to 2012 was divided into intrauterine transfer group (209 cases), neonatal transfusion group (211 cases) and hospital delivery group (385 cases) according to different modes of transport. The risk factors of maternal age, morbidity and prognosis of early and late preterm infants were compared. Results The incidence of premature rupture of membranes, gestational hypertension, clinical amniitis, prenatal antibiotic use rate, 24 hours prenatal hormone utilization rate and iatrogenic preterm birth in neonatal transit group were lower than those in the other two groups. Spontaneous preterm birth The rate of premature rupture of membranes, prenatal antibiotic use and clinical amniitis incidence were higher in intrauterine transfer group and delivery group. The incidence of hypothermia, critical neonatal score and asphyxia High, 1 minute and 5 minutes Apgar score low; intrauterine transport group idiopathic respiratory distress syndrome incidence is low, the incidence of severe pneumonia, low birth weight, very low birth weight, high incidence of late septicemia. Conclusion Intrauterine transfer of preterm infants to obstetric centers with neonatal intensive care reduces the incidence of asphyxia, idiopathic respiratory distress syndrome and hypothermia and does not reduce mortality in preterm infants.