Abstract: Objective To analyze the risk factors of prognosis of extremely premature infants(EPI, ＜28 weeks) hospitalized in the Neonatal Intensive Care Unit (NICU) of Qingdao Women and Children's Hospital, in order to provide reference for the treatment.Methods Clinical data of 124 cases of EPI enrolled in the NICU of Qingdao Women and Children's Hospital from January 2017 to December 2020 were retrospectively analyzed. Differences between the survival (n=75) group and death group (n=49) were analyzed. Then binary Logistic regression model was established to analyze the risk factors for poor prognosis.Results Among 124 cases, 67 cases (54.0%) were male infants. The birth weight ranged from 680 g to 1 520 g, the gestational age ranged from 24⁺³ weeks to 27⁺⁶ weeks, and the overall survival rate was 60.5%.There were significant differences between the survival group and the death group in 13 indicators, including birth weight, gestational age, twins, antenatal corticosteroids, using pulmonary surfactant, invasive ventilation, non-invasive ventilation, duration of non-invasive ventilation, total oxygen therapy time, complicated with neonatal respiratory distress syndrome, intraventricular hemorrhage, early-onset sepsis, neonatal necrotizing enterocolitis (P＜0.05). Multivariate Logistic regression analysis showed intraventricular hemorrhage was risk factors for poor prognosis(OR=5.518, 95%CI:1.186 - 25.685,P=0.029),and non-invasive ventilation was protection factor(OR=0.006, 95%CI:0.001 - 0.051, P＜0.001).Conclusions The survival rate of EPI is improving, but there is still a gap from the developed countries. Intraventricular hemorrhage is an important risk factor for the prognosis of EPI. So it is suggested to treat complications effectively in early stage, thereby improving the survival rate of EPI.

Key words: survival rate, extremely premature infants, non-invasive ventilation

摘要： 目的 分析新生儿重症监护室(NICU)住院治疗的超未成熟儿(EPI,＜28 周)的临床特点及不良预后的危险因素,为临床治疗提供参考依据。方法 收集青岛妇女儿童医院NICU 2017年1月-2020年12月出院的124例EPI的临床资料进行回顾性分析。分析存活组(75例)和死亡组(49例)的相关因素,构建二元Logistic回归模型分析影响预后的相关因素。结果 124例患儿中,男67例(54.0%)。出生体重680～1 520 g,胎龄24⁺³～27⁺⁶周,总存活率60.5%。存活组和死亡组的出生体重、胎龄、双胎、产前应用糖皮质激素、使用肺表面活性物质、有创通气时长、无创通气、无创通气时长、总氧疗时长、并发新生儿呼吸窘迫综合征、脑室内出血、早发型败血症、新生儿坏死性小肠结肠炎比较,差异均有统计学意义(P＜0.05),多因素Logistic回归分析显示脑室内出血是影响预后的危险因素(OR=5.518,95%CI:1.186～25.685, P=0.029),无创通气是保护因素(OR=0.006,95%CI:0.001～0.051,P＜0.001)。结论 EPI的存活率不断提高,但与发达国家相比仍有一定差距。脑室内出血是影响EPI预后的重要危险因素。早期有效处理各种并发症,可提高EPI的存活率。

关键词: 存活率, 超未成熟儿, 无创通气