CAJ | 학술논문

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.
목적:탐토영향선천성식관폐쇄환인위산기사망적위험인소,위제고환인적존활솔제공과학적의거.방법:1986년9월～1993년12월대잉28주지출생후7천적위산인진행감측,병취수집적195례선천성식관폐쇄병례진행사망위험인소분석.결과:선천성식관폐쇄적위산기병사솔위66.7%,기중신생인7천내사망소점비례(78.5%)현저고우사태、사산소점비례(21.5%,P＜0.001).사망환인적출생체중구성비불동우활산환인(P＜0.01),저체중인비례증가.35.9%적병례위다발기형,병사솔(85.7%)현저고우단발기형환인(56.0%,P＜0.01).사망환인반발적엄중기형이소화(23%)、기육골격(21%)、심혈관(15%)급호흡(13%)등계통다견,이활산환인중반발심혈관기형적비례유명현증가(27%).결론:환인출생체중화반발기형시영향환인위산기사망적위험인소.
Objective:To study the factors influencing perinatal death,to increase the survivals and to predict the prognosis of congenital esophageal atresia(EA).Methods:The records of 195 cases with EA including stillbirth and early neonatal death,collected from 30 provinces,municipals and autonomous regions between September 1986 and December 1993 were studied.Results:The perinatal mortality of EA was 66.7%,among which the proportion of early neonatal death(＜7 days) was significantly higher than that of the fetal death (78.5% vs 21.5%,P＜0.001).35.9% of them had multiple malformations making the mortality significantly higher than cases of simple EA(85.7% vs 56.0%,P＜0.001).Among the dead cases,there was a higher proportion of associated anomalies including the major defects in digestive system(23%),musculoskeletal(21%),cardiac(15%) and urogenital(13%) etc.Conclusions:The birthweight of the stillbirth is significantly different from that of livebirth(P＜0.01).Low birthweight and associated anomalies may be the main factors of perinatal death in the cases of EA.