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目的总结本院NICU住院超过30 d早产儿的临床特点,分析导致住院时间长的原因。方法选择2011年1月—2014年12月本院NICU住院超过30 d的104例早产儿为研究对象,采用回顾性分析方法,对性别、胎龄、出生体质量、孕母导致早产的高危因素、Apgar评分、住院期间合并症、转归、住院费用等进行总结和分析。结果在这104例早产儿中,男62例,女42例,平均胎龄(31.0±2.1)周,平均出生体质量(1 506±341)g,其母妊高症、重度子痫前期、胎膜早破是导致早产主要原因(64例,67.8%),5 min Apgar评分<7分的占71.7%,合并症中常见的以新生儿呼吸窘迫综合征(NRDS)最多见,共89例(85.6%),84例(80.8%)患儿有呼吸机使用史,其中有创机械通气60例(57.7%),平均呼吸机使用时间(14.3±9.9)d,使用肺表面活性剂的87例(83.7%),其次是新生儿肺炎和呼吸机相关性肺炎(61.5%)、呼吸暂停(48.1%)、新生儿败血症(40.4%)、慢性肺病(32.7%)。好转出院90例(86.5%),放弃11例,死亡3例,出院时宫外发育迟缓80例(76.9%),有33例出院前行头颅MRI或CT、脑干诱发电位检查,均有不同程度异常。平均住院时间(40.7±10.8)d,人均住院费用(50 299±18 314.2)元。结论胎龄、出生体质量、合并症多且重是导致早产儿住院时间长的主要原因,而合并症中仍以呼吸系统疾病和感染为主,积极预防早产和治疗各种早产儿并发症是缩短早产儿住院时间的重要举措。
Objective To summarize the clinical characteristics of NICU in our hospital for more than 30 days and analyze the reasons for the long hospital stay. Methods A total of 104 preterm infants with NICU hospitalized for more than 30 days in our hospital from January 2011 to December 2014 were enrolled in this study. Retrospective analysis was used to analyze the risk factors of preterm delivery such as gender, gestational age, birth weight, , Apgar score, complications during hospitalization, prognosis, hospitalization costs were summarized and analyzed. Results Among the 104 preterm infants, there were 62 males and 42 females, with an average gestational age of (31.0 ± 2.1) weeks and an average birth weight of (1 506 ± 341) g, with gestational hypertension, severe preeclampsia, Premature rupture of membranes is the main reason leading to premature delivery (64 cases, 67.8%), 5 minutes Apgar score <7 points accounted for 71.7%, comorbid neonatal respiratory distress syndrome (NRDS) common in 89 cases (85.6%), 84 (80.8%) had a history of ventilator use, including invasive mechanical ventilation in 60 cases (57.7%), mean ventilator use time (14.3 ± 9.9) d, the use of pulmonary surfactant 87 (83.7%), followed by neonatal pneumonia and ventilator-associated pneumonia (61.5%), apnea (48.1%), neonatal sepsis (40.4%) and chronic lung disease (32.7%). 90 cases (86.5%) were discharged after improvement, 11 cases were abandoned, 3 cases died, 80 cases (76.9%) were discharged at the time of discharge, 33 cases were examined by cranial MRI or CT and brainstem evoked potentials before discharge Abnormal level. The average length of hospital stay (40.7 ± 10.8) days and per capita hospitalization cost (50 299 ± 18 314.2) yuan. Conclusions The main causes of long hospital stay in preterm infants are gestational age, birth weight and comorbidity. The main cause of comorbidity is still respiratory diseases and infections, and the prevention of preterm labor and the complications of preterm birth are Shorten the length of hospital stay in preterm children an important measure.