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目的研究影响早产儿生长发育的危险因素以及预防措施。方法选取2015年1月-2016年7月该院接诊的523例早产儿为研究对象,其中出生时确定有EUGR的早产儿229例(EUGR组),未出现生长发育迟缓(EUGR)的早产儿294例(对照组)。对影响早产儿生长发育的各项危险因素进行单因素和Logistic多因素回归分析,并采用该院早产儿诊疗方案进行预防和治疗,观察两组早产儿产后并发症及后遗症发生情况。结果 EUGR组患儿的胎龄(31.1±2.0)周明显短于对照组(33.9±1.9)周(P<0.05),出生体重(1.81±0.32)kg明显轻于对照组(2.31±0.42)kg(P<0.05);宫内感染、妊娠期高血压疾病、胎膜早破、双胎、出生后并发症、宫内生长受限及喂养不耐受的发生率明显低于对照组(P<0.05)。Logistic多因素回归分析发现,出生体重、宫内感染、出生后并发症、宫内生长受限、胎膜早破及妊娠期高血压疾病是导致EUGR的危险因素。EUGR组早产儿并发症及后遗症发生率合计为74.24%,对照组为47.96%,两组比较差异有统计学意义(χ~2=38.588 1,P=0.000 0)。结论出生体重、宫内感染、出生后并发症、宫内生长受限、胎膜早破及妊娠期高血压疾病是导致EUGR的危险因素。对早产儿进行喂养、营养补充干预及对症支持治疗,可显著降低并发症及后遗症发生率。
Objective To study the risk factors that affect the growth and development of premature infants and preventive measures. Methods A total of 523 preterm infants admitted to our hospital from January 2015 to July 2016 were enrolled. Among them, 229 preterm infants with EUGR at birth (EUGR group), premature infants with no growth retardation (EUGR) 294 children (control group). Single factor and Logistic multivariate regression analysis were used to analyze the risk factors affecting the growth and development of premature infants. Preterm infants were treated with prophylaxis and treatment. The postpartum complications and sequelae were observed in both groups. Results The gestational age (31.1 ± 2.0) weeks in EUGR group was significantly shorter than that in control group (33.9 ± 1.9 weeks) (P <0.05). The birth weight (1.81 ± 0.32) kg in EUGR group was significantly lower than that in control group (2.31 ± 0.42) kg (P <0.05). The incidence of intrauterine infection, hypertensive disorder of pregnancy, premature rupture of membranes, twins, postnatal complications, intrauterine growth restriction and feeding intolerance were significantly lower than those in control group (P < 0.05). Logistic multivariate regression analysis found that birth weight, intrauterine infection, postnatal complications, intrauterine growth restriction, premature rupture of membranes and hypertensive disorder complicating pregnancy were risk factors for EUGR. The incidence of complications and sequelae in preterm infants in EUGR group was 74.24% and 47.96% in control group, respectively. The difference between the two groups was statistically significant (χ ~ 2 = 38.5881, P = 0.000 0). Conclusions Birth weight, intrauterine infection, postnatal complications, intrauterine growth restriction, premature rupture of membranes and hypertensive disorder complicating pregnancy are risk factors for EUGR. Feeding preterm infants, nutritional supplements and symptomatic symptomatic supportive intervention can significantly reduce the incidence of complications and sequelae.