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发育医学电子杂志  2023, Vol. 11 Issue (1): 19-24    DOI: 10.3969/j.issn.2095-5340.2023.01.004
  围产医学   论著 |新生儿 |
胎龄小于26 周超早产儿单中心救治情况分析
韩涛 许爱平 刘长根 王淑梅 张悦 李秋平 封志纯
(1. 解放军总医院儿科医学部 解放军总医院第七医学中心儿科研究所 出生缺陷防控关键技术国
家工程实验室 儿童器官功能衰竭北京市重点实验室,北京 100700;2. 河北省曲
周县医院 儿科,河北 邯郸 057250)
Analysis of treatment of extremely premature infants with gestational age <26 weeks in single-center
Han Tao, Xu Aiping, Liu Changgen, et al
(1. BeijingKey Laboratory of Pediatric Organ Failure, National Engineering Laboratory for Birth Defects Preventionand Control of Key Technology, Institute of Pediatrics, the Seventh Medical Center of PLA General Hospital,Faculty of Pediatrics, the Chinese PLA General Hospital, Beijing 100700, China; 2. Department of Pediatrics,Quzhou County Hospital, Hebei, Handan 057250, China)
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摘要 【摘要】 目的  探讨胎龄<26 周超早产儿(extremely preterm infant,EPI)的救治及转归情况。 方法 
2018 年1 月至2022 年11 月,在解放军总医院儿科医学部新生儿重症监护病房(neonatal intensive care
unit, NICU)的收治患儿中,纳入胎龄<26 周的EPI 为研究对象。采用回顾性分析的方法,通过住院登
记记录,查阅电子病历,收集研究对象住院期间的病历资料,记录患儿胎龄、出生医院、脑室周围 脑室内
出血(periventricular-intraventricular hemorrhage,PIVH)及转归等情况。统计各年度胎龄<26 周EPI 救
治例数及其所占该年度EPI 的比例,分析本院分娩的胎龄<26 周的EPI 情况、重度PIVH 发生率及治
愈好转率。 结果 2018 年1 月至2022 年11 月,解放军总医院儿科医学部收治的胎龄<26 周EPI 占
EPI 的比例分别为19.9%(38/191)、20.0%(36/180)、15.6%(14/90)、25.5%(26/102)、27.1%(29/107);除2020 年,其余年份胎龄<26 周EPI 占EPI 总数的比例呈逐年增高趋势。本院产科分娩的胎龄<26 周EPI占胎龄<26 周EPI 的比例也呈增高趋势,各年度分别为0.0%(0/38)、5.6%(2/36)、14.3%(2/14)、15.4%(4/26)、41.4%(12/29);2021、2022 年度,宫内转运EPI 分别为4 例、12 例。各年度胎龄<26 周EPI 发生重度PIVH 者占该年度胎龄<26 周EPI 的比例分别为29.0%(11/38)、36.1%(13/36)、28.6%(4/14)、34.6%(9/26)、27.6%(8/29)。各年度胎龄<26 周EPI 的治愈好转率分别为76.3%(29/38)、55.6%(20/36)、71.4%(10/14)、57.7%(15/26)、65.5%(19/29);相较于其他年度,2022 年度虽收治23 周EPI 明显增多,但总体放弃治疗及死亡数明显减少,治愈好转率增高。 结论 2018 年1 月至2022 年11 月,解放军总医院儿科医学部收治的胎龄<26 周EPI 占EPI 总数的比例呈逐年增高趋势,但重度PIVH 发生率并未随之升高;与前几年比较,2022 年对胎龄23 周EPI 的救治更加积极,治愈好转率增高。
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关键词:  超早产儿  小胎龄早产儿  脑室周围 脑室内出血  救治情况  转归    
Abstract: 【Abstract】 Objective To investigate the treatment and outcome of extremely preterm infant(EPI) with gestational age <26 weeks. Method From January 2018 to November 2022, EPIs with
gestational age <26 weeks in neonatal intensive care unit (NICU), Department of Pediatrics, the Chinese
PLA General Hospital were included in the study. The medical records during hospitalization were collected
through hospitalization registration records and electronic medical records, and the gestational age, birth
hospital, periventricular -intraventricular hemorrhage (PIVH) and outcome of the infants were recorded by
retrospective analysis. The annual number of EPIs with gestational age <26 weeks treated and their proportionin the annual number of EPIs were counted, and the incidence of severe PIVH and the cure or improvementrate were analyzed. Result From January 2018 to November 2022, the proportion of EPIs with gestationalage <26 weeks in the total number of EPIs admitted was as follows: 19.9% (38/191), 20.0% (36/180), 15.6%(14/90), 25.5% (26/102) and 27.1% (29/107). Except for 2020, the number of EPIs with gestational age < 26 weeksincreased year by year. The number of EPIs with gestational age <26 weeks born in Department of Obstetricsof this Hospital increased respectively, accounting for 0.0% (0/38), 5.6% (2/36), 14.3% (2/14), 15.4% (4/26)and 41.4% (12/29) of the annual number of EPIs with gestational age <26 weeks. Four and 12 cases of EPIs weretransferred prenatally. Among each year the proportion of EPIs with severe PIVH at gestational age <26 weekswas 29.0% (11/38), 36.1% (13/36), 28.6% (4/14), 34.6% (9/26) and 27.6% (8/29), respectively. The cure orimprovement rate of EPIs with gestational age <26 weeks from 2018 to 2022 were 76.3% (29/38), 55.6%(20/36), 71.4% (10/14), 57.7% (15/26) and 65.5% (19/29) respectively. Compared with other years, therewas a significant increase in EPIs at 23 weeks in 2022, but the overall number of treatment abandonment anddeath was significantly reduced, and the rate of cure improvement was increased. Conclusion From January2018 to November 2022, the proportion of EPIs with gestational age <26 weeks in the total number of EPIs in
Faculty of Pediatrics, the Chinese PLA General Hospital increased gradually, but the incidence with severe PIVHdoes not change significantly. Compared with previous years, the treatment of EPIs at 23 weeks gestational age ismore active in 2022, and the recovery rate increases.
Key words:  Extremely preterm infant    Preterm infant with small gestational age    Periventricularintraventricular hemorrhage    Treatment situation    Outcome
收稿日期:  2022-12-06                     发布日期:  2023-01-30     
基金资助: 全军计划生育专项课题(20JSZ16)
通讯作者:  封志纯    E-mail:  zhjfengzc@126.com
引用本文:    
韩涛 许爱平 刘长根 王淑梅 张悦 李秋平 封志纯. 胎龄小于26 周超早产儿单中心救治情况分析[J]. 发育医学电子杂志, 2023, 11(1): 19-24.
Han Tao, Xu Aiping, Liu Changgen, et al. Analysis of treatment of extremely premature infants with gestational age <26 weeks in single-center. Journal of Developmental Medicine(Electronic Version), 2023, 11(1): 19-24.
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