889例早产儿的预后及其影响因素分析

摘要

Objective To investigate the prognosis of premature infants and its influence factors. Methods A retrospective study was designed, and a total of 724 pregnant women with premature delivery in the Third Affiliated Hospital of Guangzhou Medical College, Guangzhou Severe Maternal Treatment Center from Jun. 2008 to Dec. 2009 were included in our study, with 889 premature infant. The prognosis of premature infants and its influence factors were analyzed. Results (1) The main complications of premature infant were asphyxia (11.40%), RDS (5.29%), pneumonia (6.64%), anemia (12.37%), acid-base imbalance (27.00%), retinopathy (6.97%). (2) The mortality rate, incidence of asphyxia, NRDS and pulmonary hemorrhage of premature infant were negatively correlated with gestational age and neonatal weight. (3) Plmonary hemorrhage, RDS and MSOF were the main causes of death for premature infant. (4) Factors of unfavourable prognosis for premature infant were gestational age, neonatal weight, asphyxia, RDS, pneumonia, alimentary tract hemorrhage, acid-base imbalance, and PROM, prccclampsia, fetal distress, polyhy-dramnios or oligohydramnios of pregnant woman (P<0.05). Conclusion The control of the risk factors of premature delivery can avoid or delay the occurrence of premature birth, improved maternal and neonatal outcomes.%目的 观察早产儿的预后并探讨其影响因素.方法 选取广州医学院第三附属医院、广州市重症孕产妇救治中心2008年1月至2009年12月间分娩的889例早产儿,分析早产儿的结局及影响早产儿预后的因素.结果 (1)早产儿的主要并发症有窒息(11.4%)、NRDS (5.29%)、肺炎(6.64%)、贫血(12.37%)、酸碱失衡(27%)、视网膜病变(6.97%)等.(2)早产儿胎龄、出生体重与窒息、NRDS、肺出血等并发症发生率和死亡率与呈负相关(P<0.05).(3)早产儿死亡原因前三位分别为肺出血、NRDS及多器官衰竭.(4)早产儿预后不良的相关因素是:早产儿低胎龄、低出生体重、窒息、NRDS、肺出血、消化道出血、酸碱失衡,孕产妇方面的因素有胎膜早破、子痫前期、胎儿窘迫、羊水过多或过少(P<0.05).结论 控制早产高危因素,避免或延迟早产的发生,将降低早产儿近期并发症发生率和围产儿死亡率,明显改善早产儿预后.