【摘要】：研究目的：回顧性分析極低出生體重兒(VLBWI)發(fā)生原因、合并癥、臨床救治方法及其轉(zhuǎn)歸,了解目前VLBWI的救治現(xiàn)狀,提高救治水平及生存質(zhì)量。 研究對(duì)象及方法：選用山東省立醫(yī)院新生兒科在2011年1月至2012年7月收治的極低出生體重兒160例為研究對(duì)象,依照生后體重分為1000g-1200g、12011500g,按胎齡分為28w-30w、30w-32w兩組,采取調(diào)查表回顧性分析對(duì)其發(fā)生原因、常見并發(fā)癥、治療措施、轉(zhuǎn)歸進(jìn)行統(tǒng)計(jì)分析。 結(jié)果：160例研究對(duì)象中VLBWI合并癥以NRDS、肺炎為主,發(fā)生率分別為71.9%、57.5%；治療措施中接受吸氧治療占81.3%,平均用氧時(shí)間為(7.0±11.6)d,接受肺表面活性物質(zhì)(PS)替代治療占69.4%；接受CPAP治療占43.1%,行呼吸機(jī)治療占18.1%,接受靜脈營養(yǎng)占81.3%,靜脈營養(yǎng)的時(shí)間平均為(6.7±1.9)d,平均成功開奶日齡為(7.5±4.1)d,使用血管活性藥物如多巴胺、多巴酚丁胺等占52.5%。轉(zhuǎn)歸情況：160例患兒治愈率91.2%,放棄率為4.4%,死亡率為4.4%。 結(jié)論：1.RDS是影響VLBWI存活率的首要并發(fā)癥,本資料發(fā)生率高達(dá)71.9%,其它的合并癥依次為肺炎、貧血、敗血癥、低血糖、ROP。 2.救治措施中,肺表面活性物質(zhì)的應(yīng)用是搶救VLBWI成功的關(guān)鍵,本資料69.4%患兒均接受PS治療。 3.ROP是VLBWI的重要合并癥之一,本組發(fā)生率為16.9%,提示常規(guī)篩查十分必要,可避免失明的發(fā)生。 4.孕母自身疾病是影響VLBWI發(fā)生率的危險(xiǎn)因素,依次為妊娠高血壓綜合 征、胎膜早破、妊娠期糖尿病。
[Abstract]:Objective: to retrospectively analyze the causes, complications, clinical treatment methods and outcome of (VLBWI) in very low birth weight infants, to understand the current treatment status of VLBWI, and to improve the treatment level and quality of life. Subjects and methods: 160 cases of very low birth weight infants admitted to the Department of Neonatrics in Shandong Provincial Hospital from January 2011 to July 2012 were divided into two groups according to their postnatal weight: 1000g-1200g / 12011500g and 28w-30w / 30w-32w, respectively. The causes, common complications, treatment measures and outcome were analyzed retrospectively by questionnaire. Results the main complications of VLBWI were NRDS and pneumonia, the incidence rates were 71.9% and 57.5% respectively, 81.3% of them were treated with oxygen inhalation, the average time of using oxygen was (7.0 鹵11.6) days, and that of pulmonary surfactant (PS) replacement therapy was 69.4%. The average time of intravenous nutrition was (6.7 鹵1.9) days, the mean age of successful lactation was (7.5 鹵4.1) days, the use of vasoactive drugs such as dopamine, dobutamine and so on accounted for 52.5 minutes. The cure rate was 91.2%, the abandonment rate was 4.4%, and the mortality rate was 4.4%. ConclusionRDS is the primary complication affecting the survival rate of VLBWI. The incidence of this data is as high as 71.9. The other complications are pneumonia, anemia, septicemia, hypoglycemia and ROP. 2. In the treatment measures, the application of pulmonary surfactant is the key to the successful rescue of VLBWI. 69.4% of the children received PS therapy. 3.ROP is one of the important complications of VLBWI, the incidence rate of this group is 16.9g, suggesting that routine screening is very necessary. To avoid blindness. 4. Maternal disease is a risk factor affecting the incidence of VLBWI, followed by pregnancy hypertension syndromes, premature rupture of membranes, gestational diabetes mellitus.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R722.1

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