目的 探讨双胎早产儿的临床特点,为今后临床工作提供指导.方法 采用回顾性分析方法,收集2010年6月至2012年6月在昆明医科大学第一附属医院儿科住院的593例早产儿的临床资料,包括胎龄、出生体质量及并发症等,并将593例早产儿分为2组:131例双胎早产儿为研究组,462例单胎早产儿为对照组.研究组根据分娩顺序分为大双组(64例)和小双组(67例).对各组早产儿临床资料进行统计学分析.结果 对照组早产儿胎龄为(34.23±1.90)周,研究组早产儿胎龄为(33.91 ±1.82)周,2组比较差异无统计学意义(t=1.689,P=0.092).研究组早产儿出生体质量[(1 921.64 ±414.05)g]与对照组[(2 164.98±495.85)g]比较差异有统计学意义(f=-5.209,P =0.000).研究组胎膜早破的发病率为16.79％(22/131例),对照组为32.68％(151/462例),2组比较差异有统计学意义(x2=12.472,P =0.000);研究组新生儿窒息的发病率为9.92％(13/131例),对照组为17.10％(79/462例),2组比较差异有统计学意义(x2=4.010,P=0.045);研究组呼吸窘迫综合征的发病率为6.87％(9/131例),对照组为3.03％(14/462例),2组比较差异有统计学意义(x2 =4.037,P =0.045);研究组呼吸暂停的发病率为4.58％(6/131例),对照组为0.65％(3/462例),2组比较差异有统计学意义(x2=8.085,P=0.004);研究组胎粪吸入综合征的发病率为0,对照组为3.90％(18/462例),2组比较差异有统计学意义(P=0.018);研究组新生儿低血糖症的发病率为27.48％(36/131例),对照组为16.67％(77/462例),2组比较差异有统计学意义(x2=7.738,P=0.005);研究组新生儿脓毒症的发病率为16.79％(22/131例),对照组为8.44％(39/462例),2组比较差异有统计学意义(x2=7.715,P =0.005);研究组宫外生长发育迟缓的发病率为6.10％(8/131例),对照组为2.38％(11/462例),2组比较差异有统计学意义(x2 =4.568,P=0.033).研究组中,大双组脓毒症的发病率为29.68％(19/64例),小双组为14.93％(10/67例),2组比较差异有统计学意义(x2 =4.138,P =0.042);大双组与小双组其他并发症比较差异均无统计学意义.结论 双胎早产儿在新生儿期出现呼吸窘迫综合征、呼吸暂停、新生儿低血糖症、脓毒症及宫外生长发育迟缓的发病率较单胎早产儿高,胎粪吸入综合征的发病率则以单胎早产儿发生率较高.
目的 探討雙胎早產兒的臨床特點,為今後臨床工作提供指導.方法 採用迴顧性分析方法,收集2010年6月至2012年6月在昆明醫科大學第一附屬醫院兒科住院的593例早產兒的臨床資料,包括胎齡、齣生體質量及併髮癥等,併將593例早產兒分為2組:131例雙胎早產兒為研究組,462例單胎早產兒為對照組.研究組根據分娩順序分為大雙組(64例)和小雙組(67例).對各組早產兒臨床資料進行統計學分析.結果 對照組早產兒胎齡為(34.23±1.90)週,研究組早產兒胎齡為(33.91 ±1.82)週,2組比較差異無統計學意義(t=1.689,P=0.092).研究組早產兒齣生體質量[(1 921.64 ±414.05)g]與對照組[(2 164.98±495.85)g]比較差異有統計學意義(f=-5.209,P =0.000).研究組胎膜早破的髮病率為16.79％(22/131例),對照組為32.68％(151/462例),2組比較差異有統計學意義(x2=12.472,P =0.000);研究組新生兒窒息的髮病率為9.92％(13/131例),對照組為17.10％(79/462例),2組比較差異有統計學意義(x2=4.010,P=0.045);研究組呼吸窘迫綜閤徵的髮病率為6.87％(9/131例),對照組為3.03％(14/462例),2組比較差異有統計學意義(x2 =4.037,P =0.045);研究組呼吸暫停的髮病率為4.58％(6/131例),對照組為0.65％(3/462例),2組比較差異有統計學意義(x2=8.085,P=0.004);研究組胎糞吸入綜閤徵的髮病率為0,對照組為3.90％(18/462例),2組比較差異有統計學意義(P=0.018);研究組新生兒低血糖癥的髮病率為27.48％(36/131例),對照組為16.67％(77/462例),2組比較差異有統計學意義(x2=7.738,P=0.005);研究組新生兒膿毒癥的髮病率為16.79％(22/131例),對照組為8.44％(39/462例),2組比較差異有統計學意義(x2=7.715,P =0.005);研究組宮外生長髮育遲緩的髮病率為6.10％(8/131例),對照組為2.38％(11/462例),2組比較差異有統計學意義(x2 =4.568,P=0.033).研究組中,大雙組膿毒癥的髮病率為29.68％(19/64例),小雙組為14.93％(10/67例),2組比較差異有統計學意義(x2 =4.138,P =0.042);大雙組與小雙組其他併髮癥比較差異均無統計學意義.結論 雙胎早產兒在新生兒期齣現呼吸窘迫綜閤徵、呼吸暫停、新生兒低血糖癥、膿毒癥及宮外生長髮育遲緩的髮病率較單胎早產兒高,胎糞吸入綜閤徵的髮病率則以單胎早產兒髮生率較高.
목적 탐토쌍태조산인적림상특점,위금후림상공작제공지도.방법 채용회고성분석방법,수집2010년6월지2012년6월재곤명의과대학제일부속의원인과주원적593례조산인적림상자료,포괄태령、출생체질량급병발증등,병장593례조산인분위2조:131례쌍태조산인위연구조,462례단태조산인위대조조.연구조근거분면순서분위대쌍조(64례)화소쌍조(67례).대각조조산인림상자료진행통계학분석.결과 대조조조산인태령위(34.23±1.90)주,연구조조산인태령위(33.91 ±1.82)주,2조비교차이무통계학의의(t=1.689,P=0.092).연구조조산인출생체질량[(1 921.64 ±414.05)g]여대조조[(2 164.98±495.85)g]비교차이유통계학의의(f=-5.209,P =0.000).연구조태막조파적발병솔위16.79％(22/131례),대조조위32.68％(151/462례),2조비교차이유통계학의의(x2=12.472,P =0.000);연구조신생인질식적발병솔위9.92％(13/131례),대조조위17.10％(79/462례),2조비교차이유통계학의의(x2=4.010,P=0.045);연구조호흡군박종합정적발병솔위6.87％(9/131례),대조조위3.03％(14/462례),2조비교차이유통계학의의(x2 =4.037,P =0.045);연구조호흡잠정적발병솔위4.58％(6/131례),대조조위0.65％(3/462례),2조비교차이유통계학의의(x2=8.085,P=0.004);연구조태분흡입종합정적발병솔위0,대조조위3.90％(18/462례),2조비교차이유통계학의의(P=0.018);연구조신생인저혈당증적발병솔위27.48％(36/131례),대조조위16.67％(77/462례),2조비교차이유통계학의의(x2=7.738,P=0.005);연구조신생인농독증적발병솔위16.79％(22/131례),대조조위8.44％(39/462례),2조비교차이유통계학의의(x2=7.715,P =0.005);연구조궁외생장발육지완적발병솔위6.10％(8/131례),대조조위2.38％(11/462례),2조비교차이유통계학의의(x2 =4.568,P=0.033).연구조중,대쌍조농독증적발병솔위29.68％(19/64례),소쌍조위14.93％(10/67례),2조비교차이유통계학의의(x2 =4.138,P =0.042);대쌍조여소쌍조기타병발증비교차이균무통계학의의.결론 쌍태조산인재신생인기출현호흡군박종합정、호흡잠정、신생인저혈당증、농독증급궁외생장발육지완적발병솔교단태조산인고,태분흡입종합정적발병솔칙이단태조산인발생솔교고.
Objective To explore the clinical characteristics in twin premature infants in order to provide some guidance for clinical work in future.Methods The clinical data of 593 premature infants hospitalized in Department of Pediatrics,the Affiliated Hospital of Kunming Medical University were collected from June 2010 to June 2012,in terms of gestational age,birth weight and neonatal complications.A retrospective analysis was performed for the data.The premature infants were divided into 2 groups:study group of 131 twin premature infants and control group of 462 singleton premature infants.The 131 twin premature infants in study group were divided into large double group(n =64) and small double group(n =67) according to delivery time.The clinical data of premature infants in each group were statistically analyzed.Results The gestational age of study group was (34.23 ± 1.90) weeks,which in control group was (33.91 ± 1.82) weeks,and there was no significant difference between the 2 groups(t =1.689,P =0.092).The birth weight in study group [(1 921.64 ± 414.05)g] had statistically significant difference compared with control group [(2 164.98 ± 495.85) g] (t =-5.209,P =0.000).The study group of incidence of premature rupture of membranes was 16.79％ (22/131 cases)and which in the control group was 32.68％ (151/462 cases),and there was statistically significant difference between the 2 groups (x2 =12.472,P =0.000) ;the incidence of neonatal asphyxia of study group was 9.92％ (13/131 cases) and that of the control group was 17.10％ (79/462 cases),there was statistically significant difference between the 2 groups (x2 =4.010,P =0.045) ; the incidence of respiratory distress syndrome in study group was 6.87％ (9/131 cases) and that in the control group was 3.03 ％ (14/462 cases),the difference was statistically significant between the 2 groups (x2 =4.037,P =0.045) ; the incidence of apnea in study group was 4.58％ (6/131 cases) and that in the control group was 0.65％ (3/462 cases),the difference was statistically significant between the 2 groups(x2 =8.085,P =0.004) ; the incidence of meconium aspiration syndrome of study group was 0 and that of the control group was 3.90％ (18/462 cases),there was statistically significant difference (P =0.018) ;the incidence of neonatal hypoglycemia of study group was 27.48％ (36/131 cases) and that of the control group was 16.67％ (77/462 cases),the difference was statistically significant between the 2 groups (x2 =7.738,P =0.005) ;the incidence of sepsis of study group [16.79％ (22/131 cases)] was significantly higher than that of the control group [8.44％ (39/462 cases)],and the difference was statistically significant between the 2 groups (x2 =7.715,P =0.005) ;the incidence of extrauterine growth retardation of study group was 6.10％ (8/131 cases) and that of the control group was 2.38％ (11/462 cases),the difference was statistically significant between the both groups (x2 =4.568,P =0.033).In the study group,the incidence of neonatal sepsis in big double group was 29.68％ (19/64 cases),and that in small double was 14.93％ (10/67 cases),there was statistically significant difference between the 2 groups(x2 =4.138,P =0.042).The other complications between the big double group and small double group had no significant difference.Conclusions The incidence rates of acute respiratory distress syndrome,apnea,neonatal hypoglycemia,sepsis and extrauterine growth retardation of twin premature infants are higher than the singleton premature infants in the neonatal period.But the incidence rate of meconium aspiration syndrome is a higher in singleton premature infants.
