摘要:目的: 探讨如何提高早产儿存活率和生存质量。 方法 :对我院新生儿病房收治的228例早产儿的临床资料进行了回顾分析。 结果 :引起早产的母亲因素以胎膜早破、妊娠期胆汁淤积综合征及妊娠合并高血压综合征为早产的重要因素,而引起早产儿常见疾病的是新生儿肺炎,高胆红素血症及新生儿窒息等。而呼吸衰竭、新生儿休克、多器官衰竭则是引起早产儿预后不良的重要因素。 结论 :早产原因以母体因素为主,故加强孕期保健,积极防治母亲的有关并发症,同时提高新生儿急救水平,早期干预,以提高早产儿的生存质量。Abstract: Objective: To exploere the ways of promoting the survival rate and the quality of life in premature infants. Methods :The clinical data on 228 cases of premature infants treated by neonatal wards were analyzed retrospectivelly. Results : The important factors of premature are cholestasis of pregnancy syndrome, premature rupture of membbranes, and hypertemsion in prefnancy. The commom diseases in premature infants are neonatal pnecemonia, hyperbilirubinemia and asphxia, the major factors in poor prognasis are caused by neonatal shock, multiple organ failure in premature infants. Conclusion :The main reasons of premature is maternal factors. It is important to strengthen the health care during pregnancy, control the complications of mothers actively, at the same time, improve the level of neonatal first aid, intervent early, so as to imprive the quality of life in preterm infants.
摘要:目的：观察小儿反复性肺炎的发生与血微量元素的关系。方法:选择56例反复性肺炎患儿为观察组，与60例健康儿童作对照，分别测定血镉、铅、铜、锌、钙、镁、铁含量。结果:56例反复性肺炎患儿血锌、铁含量较对照组减低，差异有统计学意义（Plt;0.05）。结论:部分反复性肺炎的发生与血微量元素锌、铁缺乏有关。应对反复性肺炎患儿常规行血微量元素检测，对血微量元素缺乏者应予相应补充治疗。Abstract: Objective: To observe the relationship to the occurrence of repeated pneumonia and the microelement in blood. Methods: We chose the 56 infant patients who suffered from repeated pneumonia as the observe group while the 60 health infants as the comprise group, then test the content of cadmium， plumbum， cuprum， zinc， calcium， magnesium and ferrum in blood. Results: The content of zinc and ferrum in the patient’s blood was lower than the comparison group, and the P value was Plt;0.01 and Plt;0.05 respectively, there was obvious differentiation between the two groups. Conclusion: Occurence of part repeated pneumonia is related to the deficiency of the microelements zinc and ferrum in blood. We should detect the common content of microelement to the infant patients who suffer the repeated pneumonia, and give a complement treatment to the microelements’ deficiency infant patients.
ObjectivesTo evaluate the predicting value of bedside pulmonary ultrasound in bronchopulmonary dysplasia (BPD) in premature infants.MethodsPremature infants with gestational age below 28 weeks or birth weight below 1 500 g admitted to NICU of Chengdu Women and Children’s Central Hospital from June 2018 to June 2019 were included. Pulmonary bedside ultrasound monitoring was performed on the 3rd, 7th, 14th and 28th day after admission, and the characteristic ultrasound images were recorded and scored. BPD were diagnosed by NICHD standard. The clinical data and pulmonary ultrasound data were compared and analyzed. Then diagnostic value of bedside pulmonary ultrasound in BPD of premature infants were analyzed.ResultsA total of 81 children involving 32 BPD and 49 non-BPD were included. The sensitivity (Sen), specificity (Spe) and area under curve (AUC) of receiver operating characteristic (ROC) of the "alveolar-interstitial syndrome" within 3 days after birth and the "fragment sign" on 28 days after birth were 81.25%, 51.02%, 0.66 and 31.25%, 97.96%, 0.65, respectively. The lung ultrasound scores in the BPD group on the 3rd, 7th, 14th, and 28th day after birth were 71.99.%, 68.39%, 0.71; 87.50%, 57.14%, 0.72; 78.13%, 73.47%, 0.76 and 56.25 %, 75.51%, 0.66. Sen, Spe and ROC AUC of comprehensive evaluation of lung ultrasound predicted the occurrence of BPD been 81.25%, 63.27%, and 0.85.ConclusionsThe comprehensive evaluation of combination of "alveolar interstitial syndrome" image characteristics within 3 days after birth, "fragment sign" image characteristics after 28 days, and lung ultrasound score at different times after birth can predict the premature infants with bronchopulmonary dysplasia.
Objective To discuss how is the perinatal infant’s prognosis influenced by different cardiac function and types of heart disease in pregnant women with heart disease, and to check the importance of antenatal examination. Method Retrospective analyses were conducted on the clinical records of 102 pregnant women hospitalized due to heart disease from February 2002 to February 2011 in the First Affiliated Hospital of Xinjiang Medical University. According to the level of cardiac function, 61 patients were divided into the Level I-II group and the other 41 patients were in the Level III-IV group. Results Of all cases, 38 were congenital heart disease (37.25%), followed by 22 arrhythmia (21.57%), 17 rheumatic heart disease (16.67%), 15 perinatal cardiomyopathy (14.71%), 7 hypertensive heart disease and 3 other types of heart disease. The average gestational weeks were shorter and the neonate’s weight was lower in the Level III-IV group than the Level I-II group, with a significant difference (Plt;0.05); the incidence of premature delivery, low birth weight infant at normal gestational age, neonatal asphyxia and perinatal mortality was higher in the Level III-IV group than the Level I-II group, with a significant difference (Plt;0.05); the rate of regular antenatal examination was higher in the Level III-IV group than the Level I-II group, with a significant difference (P=0.008); and there were significant differences between the regular and irregular examination groups in the incidence of premature delivery and low birth weight infant at normal gestational age (Plt;0.05), but no significant differences were found in the incidence of asphyxia and perinatal mortality (Pgt;0.05). Conclusions Congenital heart disease is the most commonly-seen type in the pregnant women with heart disease. The maternal cardiac function directly impact the prognosis of perinatal infant, and the regular antenatal examination, timely diagnosis and treatment can improve pregnancy outcome.
ObjectiveTo observe the clinical efficacy of non-nutritional sucking and 10% glucose water plus non-nutritional sucking in relieving the venipuncture pain for premature infants. MethodA total of 167 premature infants between April and December 2014 were selected as our study subjects, and they were randomly divided into three groups:intervention group Ⅰ (n=53), intervention group Ⅱ (n=58), and the control group (without any intervention, n=56). Two minutes before venous indwelling needle puncture, blood oxygen saturation and heart rate of the infants were recorded during their quiet state. In the process of venipuncture, the intervention group Ⅰ was given non-nutritional sucking, intervention group Ⅱ was given 10% glucose water plus non-nutritional sucking, and the control group did not accept any intervention. Premature pain rating scale (PIPP) was used to compare the three groups of infants in terms of pain score, heart rate and blood oxygen saturation 1 minute and 5 minutes after intravenous indwelling needle puncture. SPSS 17.0 software was applied for statistical analysis. ResultsOf the 167 premature infants, one-time puncture was successful in 152 infants, with 46 in intervention group Ⅰ, 54 in intervention group Ⅱ, and 52 in control group. One minute after intravenous indwelling needle puncture, PIPP score of intervention group Ⅰ and Ⅱ was significantly lower than that of the control group (P<0.05). The PIPP score of intervention group Ⅱ was significantly lower than that of intervention group Ⅰ (P<0.05). One minute and 5 minutes after intravenous indwelling needle puncture, heart rate in the intervention groups was significantly lower than that in the control group (P<0.05), blood oxygen saturation in the intervention groups was signficantly higher than that in the control group (P<0.05), and they were significantly lower in intervention group Ⅱ than in intervention group Ⅰ (P<0.05). ConclusionsNon-nutritional sucking is effective in alleviating venipuncture pain for premature infants, especially when it is used together with 10% glucose water. The method is worthy of clinical promotion.
目的 评价不同复苏方法和不同药物、氧疗、物理疗法等对新生儿窒息复苏和复苏后的预防措施的有效性和安全性.方法 计算机检索Cochrane Library(2004年第3期),MEDLINE(1966～2002年) 关于新生儿窒息复苏时不同复苏方法、氧气的应用、以及不同药物、剂量、给药途径治疗和预防新生儿窒息的系统评价、随机和半随机对照试验.结果 正压通气时使用100%氧气和应用室内空气的复苏效果并无差异.胎粪污染羊水(MSAF)与较高的新生儿缺血缺氧性脑病(HIE)的发生率有关,而气管内有胎粪者无论稀稠均与胎粪吸入综合征发生率无关.窒息复苏后预防性给予亚低温疗法、抗惊厥药、纳洛酮、多巴胺等在降低新生儿病死率,继发HIE的严重程度等方面与对照组相比无显著差异.应用肺表面活性物质(PS)预防和治疗新生儿呼吸窘迫综合征(RDS),可减少死亡率和并发症.结论 应用PS预防和治疗RDS可明显减少新生儿死亡率,且胎龄lt;32周的早产儿预防用药比治疗用药效果更好;目前尚无充分证据证明窒息复苏后预防性给予亚低温疗法、抗惊厥药、纳洛酮、多巴胺等治疗的有效性.
ObjectiveTo systematically review the experience of parents caring for preterm infants after discharge from hospital. MethodsWe searched databases including The Cochrane Library, Joanna Briggs Institute Library, PubMed, EMbase, Scopus, ISI Web of Science, PsycINFO, CINAHL, CBM, CNKI and VIP from inception to May 2015, to collect qualitative studies in the experience of parents caring for preterm infants after discharge from hospital. The quality of included studies was evaluated according to JBI Critical Appraisal Tool for qualitative studies in Australia. The results were integrated by integrating methods. ResultsA total of nine studies were included. Thirty-one complete findings were grouped according to their similarities to form seven categories. These categories resulted in two synthesized findings:integration results 1:parents grow in the adaptation of their care giving roles for the preterm infants; integration results 2:they are eager and thankful for support, resource and information in this critical transition period. ConclusionHealth care workers should pay attention to the important influence of premature infants discharged from hospital on their parents. In the adaption period of premature parents, health care workers should give necessary care knowledge skills to guide the parents, to assist them to compete the role of caregivers as soon as possible and promote the healthy growth of premature infants after discharge.
Objective To systematically review the effect of adjustable fortification on feeding during preterm hospitalization. Methods We searched Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure, Wanfang, Chongqing VIP for clinical controlled trials about adjustable fortification in premature infants. The retrieval time limit was from the establishment of each database to September 2022. We selected studies according to inclusion and exclusion criteria, extracted data and assessed their quality, then used RevMan5.3 for analysis. Results A total of 5 randomized controlled studies, 1 historical controlled study and 3 case-control studies were included, including 750 premature infants. Meta-analysis results showed that compared with the standard fortification group, the differences of body weight growth rate [mean difference (MD)=1.61 g/(kg·d), 95% confidence interval (CI) (0.73, 2.49) g/(kg·d), P=0.0003], body length growth rate [MD=0.15 cm/week, 95%CI (0.01, 0.29) cm/week, P=0.04], head circumference growth rate [MD=0.19 cm/week, 95%CI (0.06, 0.31) cm/week, P=0.003], incidence rate of necrotizing enterocolitis [relative risk (RR)=0.23, 95%CI (0.07, 0.75), P=0.01] were statistically significant in the adjustable fortification group. There was no significant difference in the incidence of feeding intolerance between the two groups [RR=0.58, 95%CI (0.31, 1.11), P=0.10]. Conclusion Adjusted fortification has a positive role in promoting the physical development of premature infants without increasing the incidence of feeding intolerance and necrotizing enterocolitis. When the growth of premature infants is poor after using standard fortification, adjustable fortification can be considered. However, due to the lack of included literature, more large sample, high-quality randomized controlled studies are needed in the future to further verify the feeding effect of adjustable fortification on premature infants.
ObjectiveTo observe and analyze thyroxine levels in children with retinopathy of prematurity (ROP) and its effect on severe ROP. MethodsA retrospective clinical study. From January 2022 to December 2023, a total of 64 premature infants with severe ROP (ROP group), hospitalized in the Children's Hospital Affiliated to Zhengzhou University and with a gestational age ≤32 weeks, were included. According to a 1:2 ratio, 128 premature infants without ROP, matched for sex and gestational age, were selected as the control group. Thyroid function tests were performed 7 to 14 d after birth. The levels of thyroid-stimulating hormone, triiodothyronine, free triiodothyronine, thyroxine (T4), and free T4 (FT4) were compared and observed between the two groups. The quantitative data between groups were compared by independent samples t-test or Mann-Whitney U test; the count data were compared by χ2 test. Logistic regression was used to analyze the correlation between various variables and the occurrence of severe ROP. The predictive efficacy of the differential indicators was assessed by receiver operating characteristic (ROC) curve. ResultsCompared with the control group, T4 and FT4 levels were significantly lower in children in the ROP group, and the difference was statistically significant (t=2.572, 2.704; P=0.011, 0.008). The results of univariate logistic regression analysis showed that the Apgar scores at 1 and 5 minutes, as well as sepsis, T4, FT4, and bronchopulmonary dysplasia (BPD), were significantly associated with the occurrence of severe ROP (P＜0.05). The results of multivariate logistic regression analysis indicated that FT4 and BPD are independent risk factors for the occurrence of severe ROP (P＜0.05). The ROC curve analysis revealed that T4 had a sensitivity of 80.9% and specificity of 43.3%, while FT4 showed a sensitivity of 46.8% and specificity of 75.0%, with abnormal cutoff values set at 98.4 nmol/L for T4 and 15.65 pmol/L for FT4. ConclusionsThe T4 and FT4 level of children with severe ROP are lower than that of children without ROP in the early postnatal period. The T4 and FT4 level in the early postnatal period may have a certain correlation with the occurrence of severe ROP.
ObjectiveTo systematically review the efficacy and safety of ibuprofen for premature infants with patent ductus arteriosus. MethodsDatabases including PubMed, Ovid-EMbase, The Cochrane Library (Issue 11, 2014), CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) and quasi-RCTs about ibuprofen for premature infants with patent ductus arteriosus from inception to December 2014. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. ResultsA total of 37 RCTs, involving 2 370 patients were included. The results of meta-analysis showed that, compared with the placebo/blank group, ibuprofen could increase the closure rate of PDA (LBWI:RR=1.93, 95%CI 1.25 to 2.99，P=0.003; VLBW:RR=1.23, 95%CI 1.02 to 1.48, P=0.03; ELBWI:RR=2.86, 95%CI 1.51 to 5.41, P=0.001) and decrease the incidence of sepsis (VLBW:RR=0.21, 95%CI 0.07 to 0.64，P=0.006); Compared with the indometacin groups, ibuprofen could decrease the incidence of the increase of serum creatinine (LBWI:RR=0.11, 95%CI 0.04 to 0.37, P=0.000 2), NEC (LBWI, RR=0.52, 95%CI 0.29 to 0.95, P=0.03) and oliguria (LBWI: RR=0.30, 95%CI 0.16 to 0.56, P=0.000 2; VLBW:RR=1.40, 95%CI 1.03 to 1.92, P=0.03); Compared with the intravenous ibuprofen, Oral ibuprofen could increase the closure rate of PDA (VLBW: RR=1.35, 95%CI 1.12 to 1.62, P=0.002; ELBWI, RR=1.42, 95%CI 1.07 to 1.87, P=0.01). ConclusionCurrent evidence shows that there is not indeterminate between ibuprofen and paracetamol groups. Compared with other general drugs, ibuprofen has an advantage over curing PDA and obviously reduces side effects. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusion.