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目的:探讨影响先天性食管闭锁患儿围产期死亡的危险因素,为提高患儿的存活率提供科学的依据。方法:1986年9月～1993年12月对孕28周至出生后7天的围产儿进行监测,并就收集的195例先天性食管闭锁病例进行死亡危险因素分析。结果:先天性食管闭锁的围产期病死率为66.7%,其中新生儿7天内死亡所占比例(78.5%)显著高于死胎、死产所占比例(21.5%,P<0.001)。死亡患儿的出生体重构成比不同于活产患儿(P<0.01),低体重儿比例增加。35.9%的病例为多发畸形,病死率(85.7%)显著高于单发畸形患儿(56.0%,P<0.01)。死亡患儿伴发的严重畸形以消化(23%)、肌肉骨骼(21%)、心血管(15%)及呼吸(13%)等系统多见,而活产患儿中伴发心血管畸形的比例有明显增加(27%)。结论:患儿出生体重和伴发畸形是影响患儿围产期死亡的危险因素。
Objective: To investigate the risk factors of perinatal death in children with congenital esophageal atresia and to provide a scientific basis for improving the survival rate of children. Methods: From September 1986 to December 1993, the perinatal children from 28 weeks pregnant to 7 days after birth were monitored. Risk factors of death were analyzed in 195 cases of congenital esophageal atresia. Results: The perinatal mortality rate of congenital esophageal atresia was 66.7%. The proportion of newborns died within 7 days (78.5%) was significantly higher than that of stillbirths (21.5%, P <0.001). The birth weight of infants was different from that of live births (P <0.01), and the proportion of low birth weight infants increased. 35.9% of cases were multiple deformities, the mortality rate was 85.7%, significantly higher than that of single malformations (56.0%, P <0.01). Serious deformities associated with death in children with digestive (23%), musculoskeletal (21%), cardiovascular (15%) and breathing (13%) and other systems more common in children with live birth associated with cardiovascular malformations A significant increase (27%). Conclusion: The birth weight and concomitant deformity in children are the risk factors of perinatal death.