| 摘要: |
| [摘要]目的：回顾性分析比较2007-2016年极低和超低出生体质量儿出生率与病死率的情况，探讨此类患儿的死亡原因，为降低其死亡率提供参考。方法：通过病案室记录、出入院登记本查对并记录极低/超低出生体质量儿的基本信息，按时间分为前5年（2007-2011年）和后5年（2012-2016年）两组，统计其出生率、死亡率、死亡原因。结果：本院2007年1月至2016年12月共分娩73 716例新生儿，其中极低/超低出生体质量儿921例。前5年的平均出生率、死亡率分别为1.49%（1.04%~1.72%）、31.10%（27.10%~47.50%），后5年的平均出生率、死亡率分别为1.12%（1.02%~1.33%）、23.68%（20.00%~26.41%），后5年与前5年比较出生率及死亡率均明显下降，差异有统计学意义（P<0.01）。<28周组、28~32周组、>32周组VLBW和ELBW总体死亡构成比分别为47.89%、22.09%、12.54%，差异有统计学意义（P<0.01），死亡前4位主要病因分别均为新生儿呼吸窘迫综合征、重度窒息、新生儿畸形、新生儿肺出血。但市区和周边区县患儿死亡原因的具体构成比不同：市区患儿呼吸窘迫综合征、重度窒息、新生儿畸形、肺出血死亡构成比分别为52.63%、23.68%、6.58%、5.26%；周边区县患儿呼吸窘迫综合征、重度窒息、新生儿畸形、肺出血死亡构成比分别为60.82%、28.07%、9.36%、7.02%，虽然周边区县患儿呼吸窘迫综合征、重度窒息、新生儿畸形及肺出血的死亡构成比均高于市区，但差异无统计学意义（P>0.05）。结论：2007-2016年12月极低/超低出生体质量儿的出生率及病死率均明显下降，死亡原因主要为呼吸窘迫综合征、重度窒息。临床应进一步提高新生儿复苏水平及肺表面活性剂产房内的及时应用，加强对周边区县地区孕期保健工作的宣教，提高孕期产前的依从性。 |
| 关键词: 出生率 病死率 回顾性研究 极低/超低出生体质量儿 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2019.02.004 |
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| 基金项目:江苏省妇幼健康科研项目，编号F201552。 |
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| Retrospective Study on 921 Cases of Very Low/Extremely Low Birth Weight Infants during 2007-2016 |
| Yan Junmei, Huang Hui, Li Qianqian, Deng Xiaoyi |
| (Jiangsu Xuzhou Maternal and Child Health Hospital, Jangsu Xuzhou 221009, China) |
| Abstract: |
| [Abstract] Objective: To retrospectively analyze and compare the fertility and mortality of very low/extremely low birth weight infants from 2007 to 2016, and to explore the causes of death and to provide reference for reducing the mortality. Methods: The basic information of the very low/extremely low birth weight infants was checked and recorded by the medical record room, all children were divided into the first 5 years (2007-2011) and the last 5 years (2012-2016) according to the time. Statistical analysis was conducted on the fertility, mortality and causes. Results: From Jan. 2007 to Dec. 2016, a total of 73, 716 newborns were delivered, of which 921 were very low/extremely low birth weight. The average fertility and mortality in the first 5 years were 1.49% (from 1.04% to 1.72%) and 31.10% (from 27.10% to 47.50%), respectively. The average fertility and mortality in the last 5 years were 1.12% (from 1.02% to 1.33%) and 23.68% (from 20.00% to 26.41%), the fertility and mortality decreased significantly in the last 5 years compared with the first 5 years, the difference was statistically significant (P<0.01). The overall mortality of very low/extremely low birth weight in the < 28-week group, 28-32 week group and > 32-week group were 47.89%, 22.09% and 12.54%, respectively, with statistically significant differences (P<0.01). The four main causes of death were neonatal respiratory distress syndrome, severe asphyxia, neonatal malformation and neonatal pulmonary hemorrhage, respectively. However, the specific composition ratio of death causes of children in urban areas and surrounding districts and counties was different, the composition ratio of death causes of respiratory distress syndrome, severe suffocation, neonatal malformation, and pulmonary hemorrhage of children in urban areas was 52.63%, 23.68%, 6.58%, and 5.26%, respectively. The composition ratio of respiratory distress syndrome, severe asphyxia, neonatal malformation and pulmonary hemorrhage in the surrounding districts and counties were 60.82%, 28.07%, 9.36%, and 7.02%, respectively, although the mortality of above indicators of the surrounding districts and counties were higher than those of urban areas, the difference was not statistically significant (P>0.05). Conclusion: From 2007 to 2016, the fertility and mortality of very low/extremely low birth weight infants decreased significantly, and the main causes of death were respiratory distress syndrome and severe asphyxia. In clinical practice, neonatal resuscitation level and timely application of pulmonary surfactant in the delivery room should be further improved, and publicity and education of prenatal health care in surrounding districts and counties should be strengthened so as to improve the prenatal compliance. |
| Key words: fertility mortality retrospective study very low/extremely low birth weight children |
