不同类型早产与围生儿存活及发病的关系-妇产科专业论文.docxVIP

— —1— 摘 要 不同类型早产与围生儿存活及发病的关系 研究生：邵芳 指导教师：王冬梅 教授 摘 要 目的：探讨不同类型早产是否与围生儿的存活及发病情况有关，进一步研究 早产分型的意义。方法：回顾性分析 489 例活胎妊娠的孕妇（孕 28～36+6 周）及 其分娩 550 个新生儿，按早产的类型将其分为自发性早产（SPB）、胎膜早破性早 产 （PPROM）、医源性早产（IPD）三组，根据单、多胎妊娠进一步分为 6 组。 对 3 组孕妇的一般临床资料，并发症，医院治疗情况，及 6 组胎儿和新生儿的临 床特征，存活 7 天围生儿的存活和发病情况进行比较分析。结果：1）SPB 组为 133 例（27.2%），PPROM 组为 207 例（42.3%），IPD 组为 149 例（30.5%）。有 539 个（98%）胎儿是活产，11 个死产，而生后 7 天存活的新生儿为 489 个（88.9%）； 2）IPD 组单胎围生儿存活率低于 SPB 组和 PPROM 组（P＜0.01），多胎围生儿存 活率差异无统计学意义；3）围生儿肺透明膜病、低蛋白血症、低钙血症在 IPD 组 单胎的发病率高于非 IPD 组；4）存活且没有发病的围生儿在 3 组单、多胎之间差 异无统计学意义（P＞0.05）；5）非条件 Logistic 回归多因素分析结果显示：Apgar5 分钟评分，孕周，剖宫产是围生儿存活的保护因素。医源性早产，小于胎龄儿是 围生儿死亡的危险因素。Apgar5 分钟评分，孕周是围生儿发病的保护因素。结论： IPD 是围生儿死亡的危险因素。IPD 组单胎围生儿的存活率低于 SPB 和 PPROM 组（P＜0.01）。存活围生儿肺透明膜病、低蛋白血症、低钙血症在 IPD 组单胎的 发病率高于非 IPD 组。 关键词：早产类型；围生儿存活率；发病率 新疆医科大学医学硕士学位论文 Study on different preterm birth types and perinatal infant survival and morbidity Postgraduate student: Shao fang Supervisor: Prof.Wangdongmei Abstract Objective: To investigate whether correlations could be found between the onset of preterm birth and perinatal infant outcome, that is, survival and morbidity. Methods: It was a retrospective analysis that 489 women with live fetuses were on admission, at 28-36+6 weeks of gestation, giving birth 550 infants. Patients were divided into 3 groups according to types of premature birth:spontaneous preterm birth (SPB), preterm premature rupture of membrane (PPROM), or iatrogenic preterm delivery (IPD). According to single birth and multiple birth pregnancy, these groups were divided into 6 groups. Maternal data which was divided into 3 groups including ordinary clinical information, pregnant complications, medical treatment was compared to among the groups. Fetus and infant data which was divided into 6 groups, the survival rate and morbidity of survival 7 days perinatal infant was compared to among the groups. Results: 1) The cause of the preterm birth was SPB in 133 of 489 (27.2%), PPROM in 207 of 489 (42.3%), IPD in 149 of 489 (30.5%).