本文選題：晚期早產(chǎn)兒　切入點(diǎn)：小于胎齡兒　出處：《昆明醫(yī)科大學(xué)》2017年碩士論文

【摘要】：[目的]本研究通過分析晚期早產(chǎn)兒中小于胎齡兒的出生一般情況、孕母危險(xiǎn)因素及生后患病情況,旨在為臨床干預(yù)及管理晚期早產(chǎn)兒中的小于胎齡兒,提供理論依據(jù)。[方法]收集昆明醫(yī)科大學(xué)第二附屬醫(yī)院兒科新生兒室2015年1月至2016年12月共1023例住院新生兒病歷資料。依據(jù)胎齡與出生體重的關(guān)系將收集的新生兒分為三組,分別為晚期早產(chǎn)兒中小于胎齡兒組,晚期早產(chǎn)兒中適于胎齡兒組及足月兒中小于胎齡兒組。分別比較晚期早產(chǎn)兒中小于胎齡兒與適于胎齡兒,晚期早產(chǎn)兒中小于胎齡兒與足月兒中小于胎齡兒的出生一般情況、孕母危險(xiǎn)因素及生后患病情況。[結(jié)果]1.晚期早產(chǎn)兒中小于胎齡兒較晚期早產(chǎn)兒中適于胎齡兒,出生體重低(1763±161g比2463±282g),剖宮產(chǎn)率高(86.7%比59.9%),需呼吸機(jī)支持的比例高(15%比8.3%),住院時(shí)間長(zhǎng)(13.1±1.6d比10.3±1.5d) (P均0.05)。晚期早產(chǎn)兒中小于胎齡兒較足月兒中小于胎齡兒,出生體重低( 1763±161g比2296±301g),剖宮產(chǎn)率高(86.7%比 37%) (P 均0.05)。2.晚期早產(chǎn)兒中小于胎齡兒較晚期早產(chǎn)兒中適于胎齡兒,其孕母孕期發(fā)生妊娠期高血壓、多胎妊娠、胎兒宮內(nèi)窘迫的比例更高(分別為35.2%比13.5%, 20.8%比13.4%, 13.9%比3.9%) (P均0.05)。晚期早產(chǎn)兒中小于胎齡兒較足月兒中小于胎齡兒,其孕母孕期發(fā)生妊娠期高血壓、妊娠期糖尿病、胎盤或臍帶異常、胎兒宮內(nèi)窘迫的比例更高(分別為35.2%比8.9%,6.4%比1.4%,15%比6.4%,13.3%比 4.3%, 13.9%比 3.2%) (P 均0.05)。3.晚期早產(chǎn)兒中小于胎齡兒較晚期早產(chǎn)兒中適于胎齡兒,生后發(fā)生新生兒窒息、低血糖癥、貧血的比例更高(分別為12.1%比7.4%,30.6%比21.9%,50.9%比37.9%) (P均0.05)。晚期早產(chǎn)兒中小于胎齡兒較足月兒中小于胎齡兒,生后發(fā)生電解質(zhì)紊亂、貧血、消化道出血、呼吸暫停的比例更高(分別為65.9%比29.5%,50.9%比 37.7%,6.9%比 2.5%,8.1%比 3.2%) (P 均0.05)。[結(jié)論]1.晚期早產(chǎn)兒中小于胎齡兒較晚期早產(chǎn)兒中適于胎齡兒及足月兒中小于胎齡兒均更易發(fā)生生后并發(fā)癥,其中新生兒窒息、低血糖癥的發(fā)生可能與其小于胎齡有關(guān);而電解質(zhì)紊亂、貧血、消化道出血、呼吸暫停的發(fā)生可能與其晚期早產(chǎn)有關(guān)。2.患有妊娠期高血壓疾病或發(fā)生胎兒宮內(nèi)窘迫的孕母,更易分娩出晚期早產(chǎn)兒中小于胎齡兒。3.晚期早產(chǎn)兒中小于胎齡兒的發(fā)生,與孕母的病理生理狀態(tài)有關(guān),應(yīng)加強(qiáng)孕母危險(xiǎn)因素的監(jiān)測(cè)及晚期早產(chǎn)兒中小于胎齡兒生后并發(fā)癥的早期防治,改善其近期及遠(yuǎn)期結(jié)局。
[Abstract]:[objective] by analyzing the general conditions of birth, maternal risk factors and postnatal morbidity in late preterm infants, the purpose of this study was to provide clinical intervention and management of small gestational age infants in late preterm infants. [methods] to collect the medical records of 1023 hospitalized newborns in the Department of Pediatrics newborns, second affiliated Hospital of Kunming Medical University from January 2015 to December 2016. According to the relationship between gestational age and birth weight, the collected newborns were divided into three groups. They were small gestational age group of late premature infants, suitable gestational age group of late premature infants and small gestational age group of term infants. The general conditions of birth, maternal risk factors and postnatal morbidity in late premature infants with less than gestational age and term infants. [results] 1. In late preterm infants, the smaller premature infants are more suitable for gestational age than those in late preterm infants. The lower birth weight was 1763 鹵161g vs 2463 鹵282g / g, the rate of cesarean section was 86.7% vs 59.9g / g, the proportion requiring ventilator support was 15% higher than 8.3%, and the length of hospitalization was 13.1 鹵1.6d vs 10.3 鹵1.5drespectively. The birth weight was low (1763 鹵161g vs 2296 鹵301g / g, and the cesarean section rate was 86.7% vs 37g). The proportion of fetal distress was higher (35.2% vs 13.5%, 20.8% vs 13.4%, 13.9% vs 3.9%). Abnormal placenta or umbilical cord, the proportion of fetal distress was higher (35.2% vs 8.9% vs 1.4% vs 1.4% vs 6.4% vs 4.3%, 13.9% vs 3.2%). Hypoglycemia and anemia were higher (12.1% vs 7.4% vs 30.6% vs 21.9% vs 50.9% vs 37.9%). The proportion of apnea was higher (65.9% vs 29.5g% vs 37.7% vs 6.9% vs 2.5.1% vs 3.2cm). [conclusion] 1.The late premature infants with small gestational age were more likely to have postnatal complications than those with moderate gestational age and full-term infants. Among them, neonatal asphyxia, hypoglycemia may be related to their smaller gestational age, while electrolyte disorders, anemia, gastrointestinal bleeding, The occurrence of apnea may be related to late preterm delivery. 2. Pregnant mothers with hypertensive disorder complicating pregnancy or fetal distress are more likely to give birth to late premature infants smaller than gestational age. It is necessary to strengthen the monitoring of maternal risk factors and the early prevention and treatment of complications in late preterm infants smaller than the gestational age in order to improve the short-term and long-term outcomes.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R722.6

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