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目的探讨早产儿胃肠功能障碍的发生率、发病因素及预后。方法分析206例早产儿不同出生体质量及胎龄与胃肠功能障碍发生率的关系。比较早产儿在合并窒息、感染情况下胃肠功能障碍的发生率。检测早产儿胃肠功能障碍组及非胃肠功能障碍组乳酸(LAC)水平,计算2组病死率。结果 206例早产儿胃肠功能障碍的发生率为21.36%(44/206例)。低出生体质量儿与极低出生体质量儿胃肠功能障碍的发生率比较差异有统计学意义(2χ=13.598,P=0.000 2);胎龄≤32周的早产儿与胎龄>32周的早产儿胃肠功能障碍的发生率比较差异有统计学意义(2χ=6.904,P=0.009 0);出生后有窒息史及合并感染的早产儿胃肠功能障碍的发生率均明显升高(Pa<0.01)。胃肠功能障碍组早产儿LAC水平明显高于非胃肠功能障碍组(t=32.849,P<0.001),且2组病死率比较差异有统计学意义(2χ=6.032,P=0.014 0)。结论早产儿胃肠功能障碍的发生率较高,尤其是极低出生体质量及胎龄≤32周的早产儿,且与窒息、感染等因素有关。血LAC参数的变化可作为早产儿发生胃肠功能障碍的警示参数及诊断参考指标。早产儿出现胃肠功能障碍病死率明显增加,应重视对其早期干预。
Objective To investigate the incidence, incidence and prognosis of gastrointestinal dysfunction in premature infants. Methods The relationship between different birth weight, gestational age and gastrointestinal dysfunction in 206 preterm infants was analyzed. Premature children in the merger of asphyxia, the incidence of gastrointestinal dysfunction in the case of infection. Lactate (LAC) levels were measured in preterm infants with gastrointestinal dysfunction and non-gastrointestinal dysfunction and mortality was calculated in two groups. Results The incidence of gastrointestinal dysfunction in 206 premature infants was 21.36% (44/206 cases). There was significant difference in the incidence of gastrointestinal dysfunction between low birth weight children and very low birth weight children (2χ = 13.598, P = 0.0002); gestational age ≤32 weeks and gestational age> 32 weeks (2χ = 6.904, P = 0.009 0). The incidence of gastrointestinal dysfunction in preterm infants with asphyxia history and co-infection after birth was significantly higher than that in preterm infants (2χ = 6.904, P = 0.009 0) Pa <0.01). The levels of LAC in preterm infants with gastrointestinal dysfunction were significantly higher than those with non-gastrointestinal dysfunction (t = 32.849, P <0.001). There was also a significant difference in mortality between the two groups (2χ = 6.032, P = 0.014 0). Conclusion The incidence of gastrointestinal dysfunction in preterm infants is high, especially for those with very low birth weight and gestational age ≤ 32 weeks, which are related to asphyxia and infection. Changes in blood LAC parameters can be used as preterm infants with gastrointestinal dysfunction warning parameters and diagnostic reference index. The incidence of gastrointestinal dysfunction in premature infants significantly increased mortality, should pay attention to its early intervention.