早产儿新生儿期疾病的流行病学调查

Diseases in the Neonatal period among preterm infants: an epidemiological investigation

摘要:

目的：探讨住院早产儿新生儿期疾病分布情况及影响其转归的因素。方法：对长沙市三家医院2008年961例住院早产儿资料进行调查。结果：呼吸系统疾病最常见，占73.8%，其次为新生儿感染（败血症）（39.4%）和神经系统疾病（38.3%）。不同胎龄、不同出生体重早产儿循环系统疾病的发生率差异无统计学意义（P>0.05），但呼吸系统疾病、新生儿感染（败血症）、神经系统疾病等其他疾病的发生率及生后28 d治愈、好转率各组间差异均有统计学意义（P<0.05）。胎龄、出生体重增加是住院早产儿生后28 d结局的保护因素，新生儿窒息、高胆红素血症、新生儿硬肿症等是危险因素。结论：住院早产儿新生儿期常见疾病为呼吸系统疾病、新生儿感染（败血症）、神经系统疾病；随胎龄、出生体重增加，多数疾病的发生率呈下降趋势，治愈、好转率呈上升趋势。住院早产儿生后28 d转归的保护因素是胎龄和出生体重增加，危险因素有新生儿窒息、高胆红素血症、新生儿硬肿症等。

Abstract:

OBJECTIVE: To explore diseases in the neonatal period among hospitalized preterm infants. METHODS: The clinical data of 961 preterm infants who were hospitalized in three hospitals in Changsha in 2008 were retrospectively reviewed. RESULTS: The most common neonatal disease was respiratory system diseases (73.8%), followed by infectious diseases (39.4%) and nervous system diseases (38.3%). With the increase of gestational age and birth weight, the incidence of circulatory system diseases showed no statistically significant differences (all P＞0.05), while the incidences of other diseases, such as respiratory system diseases, neonatal infections, nervous system diseases, and the desirable outcome of the preterm infants became significantly different (all P<0.05). Increased birth weight and gestational age were the protective factors while neonatal asphyxia, hyperbilirubinemia and neonatal scleredema were the risk factors for the outcome of preterm infants. CONCLUSIONS: The common neonatal diseases for preterm infants are respiratory system diseases, neonatal infections, and nervous system diseases. The incidence of the common diseases is reduced with the increasing gestational age and birth weight. Interventions should be carefully planned based on the protective factors (increased birth weight and gestational age) and risk factors (neonatal asphyxia, hyperbilirubinemia and scleredema) of the outcomes of these diseases.