CAJ | 학술논문

目的：对青岛市妇女儿童医院新生儿重症监护室近10年早期新生儿死亡特征进行分析，探索早期新生儿死亡的原因及相应干预措施。方法收集青岛市妇女儿童医院2002年1月至2011年12月10年间新生儿重症监护室死亡新生儿病例资料，对住院早期新生儿死亡病例临床情况及主要死因进行回顾性分析。结果10年间青岛市妇女儿童医院共入院16314例新生儿，共死亡525例，生后1周内早期新生儿死亡408例，包括214例早产儿，194例足月儿，占新生儿死亡的77.71％。前后5年比较，病死率明显下降（P＜0.05）。生后1 d内、～3 d、～7 d分别死亡110例（27.00％）、192例（47.06％）、106例（25.98％），多数病例为生后3 d内死亡，且1 d内死亡患儿疾病危重度高于其他两组（P＜0.01）。10年内早期新生儿主要死因依次为：早产相关因素（97例，23.78％），重度窒息（91例，22.3％），先天畸形（66例，16.2％）等。2002-2006年早期新生儿死因前3位为重度窒息、先天畸形、呼吸窘迫综合征（RDS），2007-2011年为呼吸窘迫综合征（RDS）、重度窒息、先天畸形。早产儿死亡主要集中在32周以内（26.72％）。结论青岛市妇女儿童医院10年早期新生儿病死率逐年下降，死亡病例以3 d内最多，早产儿死亡主要集中在32周以内；早期新生儿总体死因顺位为早产、重度窒息、先天畸形，且前后五年死因顺位不同。
목적：대청도시부녀인동의원신생인중증감호실근10년조기신생인사망특정진행분석，탐색조기신생인사망적원인급상응간예조시。방법수집청도시부녀인동의원2002년1월지2011년12월10년간신생인중증감호실사망신생인병례자료，대주원조기신생인사망병례림상정황급주요사인진행회고성분석。결과10년간청도시부녀인동의원공입원16314례신생인，공사망525례，생후1주내조기신생인사망408례，포괄214례조산인，194례족월인，점신생인사망적77.71％。전후5년비교，병사솔명현하강（P＜0.05）。생후1 d내、～3 d、～7 d분별사망110례（27.00％）、192례（47.06％）、106례（25.98％），다수병례위생후3 d내사망，차1 d내사망환인질병위중도고우기타량조（P＜0.01）。10년내조기신생인주요사인의차위：조산상관인소（97례，23.78％），중도질식（91례，22.3％），선천기형（66례，16.2％）등。2002-2006년조기신생인사인전3위위중도질식、선천기형、호흡군박종합정（RDS），2007-2011년위호흡군박종합정（RDS）、중도질식、선천기형。조산인사망주요집중재32주이내（26.72％）。결론청도시부녀인동의원10년조기신생인병사솔축년하강，사망병례이3 d내최다，조산인사망주요집중재32주이내；조기신생인총체사인순위위조산、중도질식、선천기형，차전후오년사인순위불동。
Objective To analyze the main causes of early neonatal death in Qingdao Women &Children's Hospital in the latest 10 years.Methods The medical records of early neonatal death in the Qingdao Women&Children’s Hospital from January 2002 through December 201 1 were analyzed.Results A total of 16 314 neonates were available to study,and 525 of them died.The mortality of early neonatal death within a week after birth was 77.71% (408 cases),including 214 premature infants and 194 mature infants.A comparison of mortality between the first 5-year and the second 5-year showed that the underlying trend of mortality was downward (P <0.05 ).The mortalities of early neonatal death within 1 day,3 days, and 4-7 days after birth were 1 10 cases (27.00%),192 cases (47.06%),and 106 cases (25.98%), respectively,and most of the neonates died within 3 days after birth;and the number of severe neonates died within 24 hours was higher than that in other two groups (P <0.01).The leading causes of early neonatal death in 10 years were:preterm birth-related factors (97 cases,23.78%),severe asphyxia (91 cases, 22.3%),congenital malformations (66 cases,16.2%).From 2002 to 2006,the top three main causes of early newborn death were severe asphyxia,congenital malformations and acute respiratory distress syndrome (ARDS),whereas from 2007 to 2011,the leading causes of death were ARDS,severe asphyxia,and congenital malformations.In comparison of early neonatal death between different gestational ages,preterm infants’death occurred mainly in 32 weeks,accounting for 26.72%.Conclusions In our hospital,the early neonatal mortality was decreased in the latest 10 years,and majority of deaths occurred within 3 days after berth,and preterm infants’death occurred mainly in 32 weeks.The leading causes of overall early neonatal death in order of frequency were premature birth,severe asphyxia and congenital malformations,but in later 5 years this order of leading causes changed.