本文選題：早產(chǎn)兒　切入點：原因　出處：《昆明醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的回顧性調(diào)查439例早產(chǎn)兒的臨床資料,分析早產(chǎn)的病因及影響早產(chǎn)兒轉(zhuǎn)歸的相關(guān)因素,從而提出預(yù)防早產(chǎn)的措施,降低早產(chǎn)發(fā)生率。 方法1.病例來源：選擇2008年1月至2011年10月在昆明醫(yī)學(xué)院第二附屬醫(yī)院兒科新生兒病房治療的和本院產(chǎn)科出生的早產(chǎn)兒(未轉(zhuǎn)入兒科),共439例,其中兒科260例,產(chǎn)科179例。 2.病例的整理與分析：設(shè)計《早產(chǎn)兒調(diào)查表》,包括母親的一般資料(年齡、胎次、孕周、流/引產(chǎn)史、職業(yè)、有無妊娠并發(fā)癥等),胎膜早破發(fā)生情況；是否雙/多胎妊娠,有無宮內(nèi)窒息、宮內(nèi)發(fā)育遲緩；早產(chǎn)兒產(chǎn)時情況：包括出生體重,生產(chǎn)方式,Apgar評分,羊水、臍帶、胎盤情況,有無窒息史；早產(chǎn)兒的轉(zhuǎn)歸情況。 結(jié)果平均胎齡33.85±2.04周,平均出生體重2108.56±470.46g。男女比為1.386：1,男多于女,隨著出生體重增加男女比例差異無顯著性意義。孕母既往異常生育史與早產(chǎn)相關(guān)性最強。胎膜早破是引起早產(chǎn)的主要原因,其他依次為不明原因的自然早產(chǎn)、雙/多胎、胎盤因素、臍帶因素和羊水因素。28-31+6周出生的早產(chǎn)兒窒息率高于32-36+6周出生者,具有顯著性差異(p0.001)。男女存活率差異無統(tǒng)計學(xué)意義(p0.05)。孕周、出生體重與轉(zhuǎn)歸顯著相關(guān)(p0.05),孕周越大、出生體重越大的早產(chǎn)兒轉(zhuǎn)歸越好。28-31+6周組、32-36+6周組治愈好轉(zhuǎn)率分別為87.5%、97.6%。出生體重1000g、1000g-、1500g-及2500g-存活率分別為100%、91.7%、96.6%、96.8%。 結(jié)論早產(chǎn)是多因素共同作用的結(jié)果,其中孕母既往異常生育史、胎膜早破、羊水因素、原因不明、多胎、胎盤因素、臍帶因素、妊娠期高血壓疾病是早產(chǎn)的主要病因。住院早產(chǎn)兒中男女比為1.386：1,存活率男女無差異。28-31+6周組、32-36+6周組治愈好轉(zhuǎn)率分別為87.5%、97.6%。出生體重1000g、1000g-1500g-及2500g-存活率分別為100%、91.7%、96.6%、96.8%。
[Abstract]:Objective to retrospectively investigate the clinical data of 439 premature infants, analyze the etiology of premature delivery and the related factors affecting the outcome of preterm infants, and put forward some measures to prevent preterm birth and reduce the incidence of preterm delivery. Methods 1. Case sources: from January 2008 to October 2011, 439 premature infants (not transferred to paediatrics) were selected, including 260 cases of paediatrics and 179 cases of obstetrics, who were treated in the pediatrics ward of the second affiliated Hospital of Kunming Medical College and were born in our hospital. 2.Case-sorting and analysis: design "Prematures questionnaire", including the mother's general data (age, birth order, gestational week, flow / induced labor history, occupation, pregnancy complications, etc.), the occurrence of premature rupture of membranes, whether or not double / multiple pregnancy, Intrauterine asphyxia, intrauterine growth retardation; preterm delivery: birth weight, production pattern Apgar score, amniotic fluid, umbilical cord, placenta, history of asphyxia; outcome of premature infants. Results the mean gestational age was 33.85 鹵2.04 weeks, the average birth weight was 2108.56 鹵470.46 g. The ratio of male to female was 1.386: 1, male was more than female. There was no significant difference in the proportion of male and female with birth weight increase. The abnormal history of pregnancy had the strongest correlation with premature delivery. Premature rupture of membranes was the main cause of premature delivery. Placental factors, umbilical cord factors and amniotic fluid factors. The asphyxia rate of premature infants was higher than that of those born at 32-36 weeks. There was no significant difference in survival rate between male and female. There was no significant difference in survival rate between male and female. The recovery rate of preterm infants with higher birth weight was 87.5 and 97.6.The survival rates of 1000g / 100g / 1500g- and 2500g- were 100 / 91.70.96. 6 and 96. 8%, respectively. Conclusion preterm delivery is the result of multiple factors, among which the previous abnormal birth history, premature rupture of membranes, amniotic fluid, unknown causes, multiple pregnancies, placental factors and umbilical cord factors are the main causes of preterm labor. Hypertension complicating pregnancy was the main cause of preterm delivery. The ratio of male to female was 1.386: 1 in hospitalized premature infants, and the survival rate was not different between male and female. The cure rate was 87.5% and 97.6in the 32-36 week group respectively. The survival rates of 1000g 1000g-1500g- and 2500g- were 10091.7% and 96.696%, respectively.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R722.6

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