本文選題：早產(chǎn)兒 + 長沙市��； 參考：《中南大學(xué)》2009年碩士論文

【摘要】： 目的 通過對長沙市較大范圍的住院早產(chǎn)兒流行病學(xué)調(diào)查,提供有關(guān)長沙市住院早產(chǎn)兒的資料,旨在揭示長沙市住院早產(chǎn)兒發(fā)生的主要病因、新生兒期疾病分布情況及影響其轉(zhuǎn)歸的因素,為降低早產(chǎn)兒的發(fā)生率及改善其生存質(zhì)量提供理論依據(jù)。 方法 1.對中南大學(xué)湘雅二醫(yī)院、湖南省婦幼保健院、瀏陽市婦幼保健院三家醫(yī)院2008年1月～12月一年內(nèi)新生兒科全部住院早產(chǎn)兒的資料進行調(diào)查。主要內(nèi)容為:①產(chǎn)婦方面包括:母親年齡、母親疾病史、母孕史,孕婦有無妊娠期高血壓、妊娠期糖尿病、羊膜早破、胎盤早剝、前置胎盤等;②新生兒方面包括各種生理參數(shù)、有無宮內(nèi)窘迫、窒息、新生兒期疾病及生后28天結(jié)局等。 2.統(tǒng)計學(xué)方法:應(yīng)用SPSS16.0統(tǒng)計軟件包,計數(shù)資料用百分率表示,胎齡/出生體重用均數(shù)±標(biāo)準(zhǔn)差表示,分析新生兒期疾病分布規(guī)律用χ~2檢驗(樣本量小時用Fisher's確切檢驗)及相關(guān)分析,影響生后28天結(jié)局的相關(guān)危險因素采用Logistic回歸分析(P＜0.05認(rèn)為有統(tǒng)計學(xué)意義)。 結(jié)果 1.2008年新生兒科共住院早產(chǎn)兒961例,男女比為1.26:1。按胎齡分為3組:≤28周組(1.1%),胎齡(27.33±0.91)周:28～32周組(15.8%),胎齡(30.87±1.10)周,＞32周組(83.1%),胎齡(35.07±1.24)周。按出生體重分為4組:＜1000g組(0.7%),體重(886.43±57.64)g,＜1500g組(11.1%),體重(1294.16±131.63)g,＜2500g組(61.3%),體重(2061.04±260.57)g,≥2500g組(26.9%),體重(2816.59±312.61)g。 2.早產(chǎn)的主要病因依次為胎膜早破(41.6%)、多胎妊娠(28.9%)、妊娠期高血壓(16.6%)、母孕期感染(13.1%)、前置胎盤(6.8%)、妊娠期糖尿病(5.8%)、貧血(5.5%)、妊娠期膽汁淤積癥(4.7%)、肝炎(2.9%),胎盤早剝(2.4%)等。 3.早產(chǎn)兒在新生兒期疾病發(fā)生率依次為呼吸系統(tǒng)疾病(73.8%)、新生兒感染(敗血癥)(39.4%)、神經(jīng)系統(tǒng)疾病(38.3%)、代謝性酸中毒(28.9%)、高膽紅素血癥(22.9%)、消化系統(tǒng)疾病(21.7%)和血液系統(tǒng)疾病(20%)等。 4.隨著胎齡、體重的增加,早產(chǎn)兒在新生兒期疾病的總體發(fā)生率有下降趨勢。隨著胎齡、出生體重增加,除循環(huán)系統(tǒng)疾病的發(fā)生率各組間差異無統(tǒng)計學(xué)意義(P＞0.05)外,其他疾病的發(fā)生率及生后28天治愈好轉(zhuǎn)率各組間差異有統(tǒng)計學(xué)意義(P＜0.05)。 5.新生兒肺炎、新生兒呼吸窘迫綜合征、呼吸暫停、肺出血、新生兒感染(敗血癥)、顱內(nèi)出血、早產(chǎn)兒腦損傷、喂養(yǎng)不耐受、高膽紅素血癥、新生兒窒息、代謝性酸中毒、糖代謝紊亂、新生兒硬腫癥與胎齡均呈負(fù)相關(guān)(P＜0.05);新生兒肺炎、新生兒呼吸窘迫綜合征、呼吸暫停、肺出血、新生兒感染(敗血癥)、顱內(nèi)出血、早產(chǎn)兒腦損傷、喂養(yǎng)不耐受、新生兒窒息、代謝性酸中毒、糖代謝紊亂、新生兒硬腫癥與出生體重均呈負(fù)相關(guān)(P＜0.05);早產(chǎn)兒生后28天治愈好轉(zhuǎn)率與胎齡、出生體重呈正相關(guān)(P＜0.05)。 6.胎齡增加、出生體重增長是影響早產(chǎn)兒生后28天結(jié)局的保護因子;新生兒窒息、高膽紅素血癥、新生兒硬腫癥、糖代謝紊亂、新生兒感染(敗血癥)、顱內(nèi)出血是影響早產(chǎn)兒生后28天結(jié)局的危險因素。 結(jié)論 1.引起早產(chǎn)的主要病因依次為胎膜早破、多胎妊娠、妊娠期高血壓等。 2.早產(chǎn)兒最常見新生兒期疾病依次為呼吸系統(tǒng)疾病、新生兒感染(敗血癥)、神經(jīng)系統(tǒng)疾病等;隨著胎齡、出生體重的增加,多數(shù)疾病的發(fā)生率有下降趨勢,生后28天治愈好轉(zhuǎn)率呈上升趨勢。 3.胎齡增加、出生體重增長是影響早產(chǎn)兒生后28天結(jié)局的保護因子;新生兒窒息、高膽紅素血癥、新生兒硬腫癥、新生兒感染(敗血癥)、顱內(nèi)出血是影響早產(chǎn)兒生后28天結(jié)局的危險因素。
[Abstract]:objective
Through the epidemiological survey on the large range of hospitalized preterm infants in Changsha, the information about the preterm infants in Changsha was provided to reveal the main causes of the premature infants in the hospital in Changsha, the distribution of the diseases in the newborns and the factors affecting their outcome, so as to provide a theoretical basis for reducing the incidence of premature infants and improving their quality of life. According to it.
Method
1. to investigate the data of all the premature infants in the new Department of Pediatrics in three hospitals of Xiangya No.2 Hospital, Hunan maternity and child health care hospital and Liuyang maternal and child health care hospital from January 2008 to December. The main contents are: (1) maternal age, mother's disease history, mother pregnancy history, pregnant women without pregnancy hypertension, pregnancy sugar Urinary disease, premature rupture of amniotic membrane, placenta abruption, placenta previa, etc.; 2. Neonatal aspects include various physiological parameters, such as intrauterine distress, asphyxia, neonatal disease and the 28 day outcome after birth.
2. statistical method: using the SPSS16.0 statistical software package, the count data were expressed as a percentage, the gestational age / birth weight was expressed as a standard deviation, and the distribution of the diseases in the newborn period was analyzed by the chi square ~2 test (the exact test of Fisher's in the sample size) and the correlation analysis, and the related risk factors affecting the outcome of the 28 days after birth were used in the regression analysis. Analysis (P < 0.05).
Result
1.2008 years of newborn children were hospitalized with 961 preterm infants. The ratio of male and female to 1.26:1. was divided into 3 groups: 28 weeks (1.1%), fetal age (27.33 + 0.91) weeks, 28~32 weeks (15.8%), gestational age (30.87 + 1.10) weeks, 32 weeks (83.1%), and gestational age (3). Body weight (1294.16 + 131.63) g, group 2500g (61.3%), body weight (2061.04 + 260.57) g, group 2500g (26.9%), body weight (2816.59 + 312.61) g.
2. the main causes of premature birth were premature rupture of membranes (41.6%), multiple pregnancy (28.9%), pregnancy induced hypertension (16.6%), maternal infection (13.1%), placenta previa (6.8%), gestational diabetes (5.8%), anemia (5.5%), pregnancy cholestasis (4.7%), hepatitis (2.9%), and placental abruption (2.4%).
3. the incidence of premature infants in the neonatal period was respiratory disease (73.8%), neonatal infection (sepsis) (39.4%), nervous system disease (38.3%), metabolic acidosis (28.9%), hyperbilirubinemia (22.9%), digestive system disease (21.7%) and blood system disease (20%).
4. as the gestational age and weight increase, the overall incidence of the premature infants in the neonatal period has a downward trend. With the gestational age and the increase of birth weight, there is no statistical significance (P > 0.05), the incidence of other diseases and the recovery rate of 28 days after birth (P < 0). .05).
5. neonatal pneumonia, neonatal respiratory distress syndrome, respiratory apnea, pulmonary hemorrhage, neonatal infection (sepsis), intracranial hemorrhage, brain injury in premature infants, feeding intolerance, hyperbilirubinemia, neonatal asphyxia, metabolic acidosis, glucose metabolism disorder, neonatal sclerosis and gestational age (P < 0.05); neonatal pneumonia, neonatal call Respiratory distress syndrome, apnea, pulmonary hemorrhage, neonatal infection (sepsis), intracranial hemorrhage, brain injury in premature infants, feeding intolerance, neonatal asphyxia, metabolic acidosis, glucose metabolism disorder, neonatal sclerosis and birth weight were negatively correlated (P < 0.05), and the recovery rate of 28 days after birth was positively correlated with gestational age and birth weight (P < 0.05).
The increase of 6. gestational ages and the growth of birth weight are protective factors affecting the outcome of the 28 day postnatal birth. Neonatal asphyxia, hyperbilirubinemia, neonatal sclerosis, glucose metabolism disorder, neonatal infection (sepsis), intracranial hemorrhage are the risk factors that affect the 28 day outcome of the birth of premature infants.
conclusion
1. the main causes of premature birth are premature rupture of membranes, multiple pregnancy, gestational hypertension and so on.
2. the most common neonatal diseases in preterm infants are respiratory diseases, neonatal infection (sepsis), nervous system diseases, and so on. With the increase of fetal age and birth weight, the incidence of most diseases has a downward trend, and the recovery rate of the 28 days after birth is on the rise.
The increase of 3. gestational ages and the growth of birth weight are protective factors affecting the outcome of the 28 day postnatal birth. Neonatal asphyxia, hyperbilirubinemia, neonatal sclerosis, neonatal infection (sepsis), intracranial hemorrhage are the risk factors affecting the 28 day outcome of the birth of preterm infants.

【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2009
【分類號】：R722.6;R181.3

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