本文選題：雙胎早產(chǎn)兒　切入點：單胎早產(chǎn)兒　出處：《昆明醫(yī)科大學(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的： 探討雙胎早產(chǎn)兒的臨床特點,并在糾正胎齡1歲時進行神經(jīng)精神發(fā)育的隨訪評估,了解雙胎早產(chǎn)兒神經(jīng)精神發(fā)育情況及分析其危險因素,并為今后的臨床工作提供一定的指導(dǎo)。 方法： 1.收集2010年6月至2012年6月在我科新生兒病房住院的593例早產(chǎn)兒的臨床資料包括胎齡、出生體重及并發(fā)癥等,并將以上早產(chǎn)兒分為兩組：其中131例雙胎早產(chǎn)兒為研究組,462例單胎早產(chǎn)兒為對照組,對兩組臨床資料進行統(tǒng)計學(xué)分析。 2.對兩組88例早產(chǎn)兒在糾正胎齡1歲時行神經(jīng)精神發(fā)育隨訪,由我院兒童保健科專門人員采用湖南醫(yī)科大學(xué)1995年主持修訂的“貝利嬰幼兒發(fā)展量表(Bay ley scales of infant development, BSID)"測試工具進行測試,其中研究組根據(jù)貝利嬰幼兒發(fā)展量表正常測試結(jié)果分為神經(jīng)精神發(fā)育異常組(Mental development index, MDI≤79分)和神經(jīng)精神發(fā)育正常組(MDI79分),并對兩組資料進行統(tǒng)計學(xué)分析。 結(jié)果： 1.兩組臨床資料比較：出生體重、胎膜早破、新生兒窒息、呼吸窘迫綜合癥(Respiratory distress syndrome, RDS)、呼吸暫停、胎糞吸入綜合征(Meconium aspiration syndrome, MAS)、新生兒低血糖癥、新生兒敗血癥及宮外生長發(fā)育遲緩差異有統(tǒng)計學(xué)意義。 2.研究組中大雙與小雙的新生兒敗血癥發(fā)病率差異有統(tǒng)計學(xué)意義。(P0.05)。 3.研究組MDI得分頻數(shù)分布呈偏態(tài)分布,其中59%為神經(jīng)精神發(fā)育異常(MDI≤79分)；但對照組MDI得分頻數(shù)分布呈近似正態(tài)分布,其中僅12%為神經(jīng)精神發(fā)育異常。 4.雙胎早產(chǎn)兒頭圍、身長、體重、MDI、PDI均低于單胎早產(chǎn)兒,差異有統(tǒng)計學(xué)意義(P0.05)。 5.單因素分析中雙胎早產(chǎn)兒神經(jīng)精神發(fā)育異常(MDI≤79分)的高危因素有胎齡、出生體重、母親育齡、父母親文化程度、喂養(yǎng)方式、新生兒高膽紅素血癥、新生兒低血糖癥、新生兒敗血癥、感染。 6.多因素Logistic回歸分析顯示新生兒高膽紅素血癥是雙胎早產(chǎn)兒神經(jīng)精神發(fā)育異常的獨立危險因素。 結(jié)論： 1.雙胎早產(chǎn)兒在新生兒期出現(xiàn)RDS、呼吸暫停、新生兒低血糖癥、敗血癥及宮外生長發(fā)育遲緩的發(fā)病率較單胎早產(chǎn)兒高。但新生兒重度窒息、MAS的發(fā)病率則以單胎早產(chǎn)兒發(fā)生率較高。 2.同胎齡雙胎早產(chǎn)兒的神經(jīng)精神發(fā)育落后于單胎早產(chǎn)兒。 3.新生兒高膽紅素血癥是導(dǎo)致雙胎早產(chǎn)兒神經(jīng)精神發(fā)育異常的高危因素,故應(yīng)早期積極處理新生兒高膽紅素血癥,有利于促進雙胎早產(chǎn)兒的神經(jīng)精神發(fā)育。
[Abstract]:Objective:. To investigate the clinical characteristics of twin premature infants and to evaluate the neuropsychiatric development at the corrected gestational age of 1 year, to understand the neuropsychiatric development of twin premature infants and to analyze its risk factors. And to provide certain guidance for the future clinical work. Methods:. 1. The clinical data of 593 premature infants hospitalized in our department from June 2010 to June 2012 were collected, including gestational age, birth weight and complications. The above premature infants were divided into two groups: 131 twin premature infants as the study group and 462 single premature infants as the control group. The clinical data of the two groups were analyzed statistically. 2. The neuropsychiatric development of 88 premature infants in two groups were followed up at the corrected gestational age of 1 year. Ley ley scales of infant development (BSIDD), which was revised by Hunan Medical University in 1995, was used to test children's health department in our hospital. According to the normal test results of Bailey Infant Development scale, the study group was divided into two groups: mental development index (MDI 鈮，

本文編號：1563195