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目的分析极低出生体重儿(VLBWI)临床特点及影响早期救治结局的相关因素。方法对2008年1月至2013年1月我院新生儿重症监护室(NICU)住院的VLBWI临床资料进行回顾性分析,对影响早期救治结局的相关因素进行Logistic回归分析。结果 VLBWI主要分布在1250~1499 g(57.1%),胎龄29~32周(72.3%)。新生儿呼吸窘迫综合征(RDS)在<1000 g组、胎龄25~28周的发生率明显高于其他组;喂养不耐受在1250~1499 g组的发生率明显高于其他组;肺炎在33~36周的发生率明显高于其他组;贫血在1250~1499 g的发生率明显高于其他组。临床转归差108例(38.6%),转归好172例(61.4%)。多因素Logistic回归分析显示,胎龄越大VLBWI的转归越好(OR=0.979,95%CI 0.955~0.997),RDS(OR=3.739,95%CI 1.955~7.007)、肺炎(OR=2.315,95%CI 1.097~4.677)是其危险因素。结论对VLBWI可根据胎龄及出生体重不同,有目的的预防及治疗并发症,可以提高存活率。
Objective To analyze the clinical characteristics of very low birth weight infants (VLBWI) and the related factors that influence the outcome of early treatment. Methods The clinical data of VLBWI hospitalized in neonatal intensive care unit (NICU) in our hospital from January 2008 to January 2013 were analyzed retrospectively. Logistic regression analysis was performed on the related factors affecting the outcome of early treatment. Results VLBWI mainly distributed in 1250 ~ 1499 g (57.1%), gestational age 29 to 32 weeks (72.3%). Neonatal respiratory distress syndrome (RDS) in <1000g group, gestational age at 25-28 weeks was significantly higher than other groups; feeding intolerance in 1250 ~ 1499g group was significantly higher than the incidence of pneumonia; The incidence of 33-36 weeks was significantly higher than the other groups; the incidence of anemia in 1250-1499 g was significantly higher than the other groups. The clinical outcome was poor in 108 cases (38.6%) and good in 172 cases (61.4%). Multivariate logistic regression analysis showed that the higher the gestational age, the better the prognosis of VLBWI (OR = 0.979, 95% CI 0.955-0.997), RDS (OR = 3.739, 95% CI 1.955-7.007) 95% CI 1.097 ~ 4.677) is the risk factor. Conclusion According to the different gestational age and birth weight, VLBWI can prevent and cure complications purposefully and improve the survival rate.