论文部分内容阅读
目的探讨不同程度组织学绒毛膜羊膜炎(histologic chorioamnionitis,HCA)对极早产儿的影响。方法回顾性分析四川省妇幼保健院2013年4月至2015年4月收治的极早产儿213例,根据胎盘病理检查是否发生HCA分为HCA组(115例)和对照组(98例)。HCA组又根据病理分期结果分成Ⅰ期组(48例)、Ⅱ期组(37例)和Ⅲ期组(30例)。分别比较极早产儿各组入院2 h内白细胞计数、血小板计数、C反应蛋白(C-reactive protein,CRP)值及住院期间新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)、早发型败血症(early-onset sepsis,EOS)、坏死性小肠结肠炎(necrotizing enterocolitis,NEC)、Ⅲ°以上脑室内出血(intraventricular hemorrhage,IVH)、早产儿视网膜病(retinopathy of prematurity,ROP)、支气管肺发育不良(bronchopulmonary dysplasia,BPD)的发生率。结果①极早产儿HCA的检出率为53.99%。②HCA组Ⅰ、Ⅱ、Ⅲ期组比较:入院2 h内白细胞计数、血小板计数、CRP值和住院期间NRDS发生率差异均无统计学意义(P>0.05);住院期间Ⅰ、Ⅱ、Ⅲ期组EOS(分别为2.08%、8.11%、20.00%)、ROP(分别为8.33%、16.22%、30.0%)、NEC(分别为2.08%、5.41%、20.00%)、Ⅲ°以上IVH(分别为4.17%、8.11%、23.33%)和BPD(分别为6.25%、16.22%、26.67%)的发生率比较差异均有统计学意义(P<0.05)。③HCA组和对照组比较:HCA组入院2 h内CRP值[(9.01±2.58)mg/L]及住院期间EOS(8.70%)、NEC(7.83%)、IVH(10.43%)、ROP(16.52%)和BPD(14.78%)的发生率均高于对照组[(5.82±1.25)mg/L、2.04%、1.02%、3.06%、7.14%、6.12%],(P<0.05);入院2 h内白细胞计数、血小板计数和住院期间NRDS发生率两组比较差异无统计学意义(P>0.05)。结论 HCA会明显增加极早产儿多种疾病的发病率,但不增加NRDS的发病率。HCA的分期越重极早产儿的相关疾病发病率越高。
Objective To investigate the effects of histologic chorioamnionitis (HCA) on very premature infants. Methods 213 cases of very preterm preterm children admitted to Sichuan MCH from April 2013 to April 2015 were retrospectively analyzed. HCA was divided into HCA group (n = 98) and control group (HCA group) according to whether placental pathology was detected. According to the results of pathological staging, HCA group was divided into the first stage group (48 cases), the second stage group (37 cases) and the third stage group (30 cases). The levels of leukocyte count, platelet count, C-reactive protein (CRP), neonatal respiratory distress syndrome (NRDS) during hospitalization, early onset sepsis early-onset sepsis (EOS), necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH) more than â ... ¢, retinopathy of prematurity (ROP), bronchopulmonary dysplasia bronchopulmonary dysplasia, BPD). Results ① The detection rate of HCA in very premature children was 53.99%. (2) There was no significant difference in the incidence of NRDS between the two groups (Ⅰ, Ⅱ and Ⅲ) in HCCA group during the first 2 h after admission: white blood cell count, platelet count, CRP and inpatient NRDS incidence within 2 h after admission EOS (2.08%, 8.11% and 20.00% respectively), ROP (8.33%, 16.22% and 30.0%, respectively), NEC (2.08%, 5.41% and 20.00% %, 8.11%, 23.33%) and BPD (6.25%, 16.22%, 26.67% respectively) were statistically significant (P <0.05). ③HCA group and control group: CRP value (9.01 ± 2.58) mg / L within 2 h after hospital admission and EOS (8.70%), NEC (7.83%), IVH (10.43%) and ROP (16.52% ) And BPD (14.78%) were higher than those in control group [(5.82 ± 1.25) mg / L, 2.04%, 1.02%, 3.06%, 7.14% and 6.12% There was no significant difference between the two groups in the number of white blood cell count, platelet count and inpatient NRDS (P> 0.05). Conclusions HCA significantly increases the incidence of various diseases in very preterm infants but does not increase the incidence of NRDS. The higher the staging of HCA, the higher incidence of related diseases in very preterm children.