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目的探讨胎膜早破(premature rupture of the membrane,PROM)对早产儿并发症的影响。方法收取课题组各协作单位产科登记信息在2014年1月1日~2014年12月31日出生的胎龄<37周的早产儿共7684例。各协作单位派专人培训后填写统一的表格,记录相关信息,包括患儿性别、胎龄、出生体质量、有无PROM、胎盘早剥、产前激素使用、Apgar评分、羊水污染、并发症等。按有无PROM分为PROM组与对照组,统一对其临床资料进行分析。结果(1)PROM组病死率小于对照组,颅内出血、坏死性小肠结肠炎、早产儿视网膜病、支气管肺发育不良发生率均高于对照组,两组间比较差异均有统计学意义(P<0.05);OR值95%CI分析:病死率<1;颅内出血、坏死性小肠结肠炎、早产儿视网膜病、支气管肺发育不良并发症>1。(2)调整胎龄、出生体质量、性别、分娩方式、胎盘早剥、前置胎盘、产前激素、妊娠期糖尿病、妊娠期高血压病和5 min Apgar评分<7分等因素后,坏死性小肠结肠炎、早产儿视网膜病、支气管肺发育不良的发生率两组间差异均有统计学意义(P<0.05),且OR 95%CI>1,但病死率和ICH比较,差异均无统计学意义(P>0.05)。结论 PROM是早产儿并发症坏死性小肠结肠炎、早产儿视网膜病、支气管肺发育不良发生的危险因素,规范处理PROM可减少早产儿并发症NEC、早产儿视网膜病、支气管肺发育不良的发生。
Objective To investigate the effect of premature rupture of the membrane (PROM) on the complications of premature infants. Methods A total of 7684 preterm infants of gestational age <37 weeks born from January 1, 2014 to December 31, 2014 were enrolled in this study. The cooperative units sent specialists to train in a unified form and record the relevant information, including the sex, gestational age, birth weight, presence of PROM, placental abruption, prenatal hormone use, Apgar score, amniotic fluid contamination, complications, etc. . According to the presence or absence of PROM PROM group and control group, a unified analysis of their clinical data. Results (1) The mortality of PROM group was lower than that of the control group. The incidence of intracranial hemorrhage, necrotizing enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia were higher in PROM group than in control group, with significant difference between the two groups (P <0.05); OR 95% CI analysis: case fatality rate <1; intracranial hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, complications of bronchopulmonary dysplasia> 1. (2) After adjusting for gestational age, birth weight, sex, mode of delivery, placental abruption, placenta previa, prenatal hormone, gestational diabetes mellitus, gestational hypertension and 5 min Apgar score <7, There were significant differences between the two groups (P <0.05), OR 95% CI> 1, but there was no significant difference in mortality and ICH between the two groups Statistical significance (P> 0.05). Conclusions PROM is a risk factor of premature infant complications of necrotizing enterocolitis, retinopathy of prematurity and bronchopulmonary dysplasia. Standardized treatment of PROM can reduce the incidence of preterm neonatal complications such as NEC, retinopathy of prematurity and bronchopulmonary dysplasia.