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新生儿先天性高胰岛素血症胰腺次全切除一例

中华围产医学杂志 2016年第8期19卷 620-622页

作者：常利利田鸾英广东省深圳市美中宜和妇儿医院NICU 518000 广东省深圳市南山区妇幼保健院NICU 518000

患儿男性，因“生后气促11min”于2014年4月3日01：30（生后21min）由南山区妇幼保健院手术室转入该院新生儿科。患儿系第2胎第2产，出生胎龄35周^＋0，因其母“瘢痕子宫”行剖宫产娩出，无宫内窘迫及生后窒息史，出生体重4080g。

关键词：先天性高胰岛素血症新生儿科次全切除胰腺妇幼保健院出生胎龄瘢痕子宫宫内窘迫

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腹裂畸形新生儿的分娩时机影响疾病预后

世界核心医学期刊文摘（儿科学分册） 2005年第7期1卷 42-43页

作者： Ergün O. Barksdale E. Ergün F.S. D.J.Hackam 宁亮 Division of Pediatric Surgery Children's Hospital of Pittsburgh Pittsburgh PA 15213 United States

Background: The delayed onset of intestinal function in children with gastroschisis may be because of the injurious effects of amniotic fluid on the exposed *** has led to consideration of early delivery to minimize intestinal damage and improve outcome, although this has not been carefully *** authors hypothesized that timing of delivery influences outcome in children with gastroschisis, and sought to evaluate the relative impact of factors that predict outcome in this ***: All consecutive patients with gastroschisis (1992-2002) were divided into those delivered before (“early”) or after (“late”) 36 *** peel was described as “thin”or “thick,”based on operative *** measures were analyzed by univariate analyses (χ2/ Student’s t test), and logistic regression was used to identify significant factors for the length of stay (LOS) longer than the population average of 55 ***: In 75 patients, 53.4%were “early”and 46.6%were “late.”Groups were similar with respect to maternal age, birth weight, delivery mode, sex, and associated *** of bowel peel was not affected by delivery time, yet “early”patients had significantly longer LOS and time to enteral *** predictors of LOS more than 55 days included gestational age of 36 weeks or younger, time to enteral feeds of more than 26 days, and associated *** predictors included size of the defect, thickness of bowel peel, and need for ***: Delivery before 36 weeks is associated with longer hospitalization and increased tune to attainment of full feeds compared with later *** well-being should thus be the primary determinant of delivery for gastroschisis, as opposed to considerations regarding possible injurious effects to the bowel of prolonged gestation.

关键词：分娩时机腹裂畸形疾病预后出生胎龄畸形儿肠功能显著性因素肠内营养分娩时间单变量分析

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双胞胎早产儿高度近视两例

中华眼视光学与视觉科学杂志 2012年第11期14卷 700-701页

作者：石一宁胡笳石蕊杨乐李婵孙烨李静郭中兰陈研明陕西省人民医院眼科西安710068

例一：患儿，男，4．5岁。发现视物眯眼一年半。一年半前（3岁时），患儿家长发现患儿存在上述症状，询问得知其视物模糊。于当地医院就诊，诊断为“近视”．给予框架眼镜配戴。近日，患儿自觉视力继续下降。

关键词：高度近视早产儿双胞胎视物模糊医院就诊眼镜配戴出生胎龄患儿

对极早产儿早期营养支持采用标准化肠外营养配方的评价

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世界核心医学期刊文摘（儿科学分册） 2006年第12期2卷 23-24页

作者： Lenclen R. Crauste-Manciet S. Narcy P. 郭战宏 Unitéde Réanimation Néonatale Centre Hospitalier Poissy/Saint-Germain-en-Laye10rue du champ Gaillard78300 PoissyFrance

Introduction:Parenteral nutrition (PN) plays an important role in the nutritional support of very preterm newborns. It has been suggested that a high proportion of PN orders could be *** 2002,we implemented in our unit the preparation of three standardized formulations for PN adapted to the nutritional requirements of premature infants< 32 weeks. Following this change of practice,a retrospective observational study was conducted to evaluate the relevance of the implemented standardized PN regime. Twenty premature inborn infants < 32weeks gestation who had received standardized (STD) PN in 2003 were matched for 20 infants who had received individualized(IND) PN in 2001. Adequacy of nutrition was assessed by comparing daily intravenous nutrient intake and biochemical parameters during the first week. Amino-acid intakes on day 3 were higher in the STD group (1.5±0.2 g/kg/d vs. 0.9±0.5,p< 0.001),and the calcium phosphate intakes were better *** cumulated intake of amino acids for the first week was greater in the STD group (+20%; p=0.0003). Biochemical parameters were similar in both groups. Insulin infusions were less frequent in the STD group (p<0.06). Conclusion:Standardized parenteral formulations provided higher early intakes of amino acid and glucose,a better calcium phosphate ratio,and a greater amount of amino acid intakes during the first week whilemaintaining the same biochemical parameters. This strategy forms part of an approach concerning quality control and the respect of good professional practice for the preparation of parenteral nutrition solutions.

关键词：营养支持肠外营养出生胎龄营养素摄入胰岛素注射适当性生化参数执业规范钙磷比例中起

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早产儿视网膜病变发病的相关因素及转归

医疗装备 2016年第20期29卷 130-131页

作者：刘琳瑞金市妇幼保健院江西瑞金342500

目的对早产儿视网膜病变发病的相关因素及病变转归进行分析,为今后的临床诊治工作提供有价值的参考信息。方法选取2012年12月至2014年12月新生儿监护病房住院诊断为早产儿视网膜病变的患儿共50例作为研究对象,对监护病房早产儿的相关因... 详细信息

目的对早产儿视网膜病变发病的相关因素及病变转归进行分析,为今后的临床诊治工作提供有价值的参考信息。方法选取2012年12月至2014年12月新生儿监护病房住院诊断为早产儿视网膜病变的患儿共50例作为研究对象,对监护病房早产儿的相关因素进行logistic回归分析,观察与视网膜病变有关的相关独立因素。结果 Logistic回归分析发现,出生胎龄因素与严重早产儿视网膜病变的发生存在相关性(P出生胎龄、视网膜出血等因素与严重早产儿视网膜病变的发生相关,在今后的临床工作中,应给予足够的重视。

关键词：出生胎龄视网膜出血早产儿视网膜病变危险因素转归

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重视我国超早产儿的救治

发育医学电子杂志 2015年第4期3卷 207-211页

作者：李秋平封志纯北京军区总医院附属八一儿童医院新生儿科北京100700

超早产儿(extreme premature infants,EPI)是指出生胎龄<28周的早产儿,由于器官发育极不成熟,易出现多种合并症,死亡率和致残率均很高。在我国EPI长期以来被归于晚期流产儿范畴。但随着早产儿救治技术的发展,EPI存活率和远期预后均有明... 详细信息

超早产儿(extreme premature infants,EPI)是指出生胎龄<28周的早产儿,由于器官发育极不成熟,易出现多种合并症,死亡率和致残率均很高。在我国EPI长期以来被归于晚期流产儿范畴。但随着早产儿救治技术的发展,EPI存活率和远期预后均有明显改善。尤其是在美、日、欧等发达国家与地区,EPI的存活率已达到极高水平,远期生存质量也有明显改善~[1]。

关键词：超早产儿流产儿出生胎龄器官发育 extreme premature 新生儿科超低出生体重儿肠道外营养母乳库

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痉挛型脑性瘫痪MRI研究

中国康复理论与实践 2007年第4期13卷 386-388页

作者：于荣侯梅孙殿荣赵建慧李玉堂陈军青岛市儿童医院残疾儿童医疗康复中心山东青岛市266011

目的探讨颅脑MRI与脑瘫类型、患儿胎龄之间的关系。方法回顾性分析224例痉挛型脑瘫患儿的MRI检查和临床资料。结果224例患儿痉挛型偏瘫27例、双瘫149例、四肢瘫48例;MRI异常201例(89.7%),其中偏瘫、双瘫、四肢瘫的异常率分别为100%、87... 详细信息

目的探讨颅脑MRI与脑瘫类型、患儿胎龄之间的关系。方法回顾性分析224例痉挛型脑瘫患儿的MRI检查和临床资料。结果224例患儿痉挛型偏瘫27例、双瘫149例、四肢瘫48例;MRI异常201例(89.7%),其中偏瘫、双瘫、四肢瘫的异常率分别为100%、87.2%和91.7%。痉挛型双瘫以脑室周围白质软化(PVL)最常见,发生率79.2%,其他类型脑损伤少见。痉挛型四肢瘫脑损伤多种多样,以PVL、足月儿类型脑损伤、先天发育畸形为主要表现,发生率分别为45.8%、20.8%和18.8%。足月儿痉挛型偏瘫以半侧损伤为主,临床表现为一侧肢体运动障碍,上肢重,下肢轻;未成熟儿痉挛型偏瘫表现为单侧或双侧PVL,临床表现为下肢重、上肢轻的偏瘫。152例PVL患儿中,发生于未成熟儿108例(71.1%)、足月儿44例(28.9%)。足月儿类型脑损伤22例,发生于足月儿20例(90.9%)。未成熟儿脑损伤类型主要为PVL,主要见于未成熟儿脑瘫,也可发生于足月儿脑瘫。足月儿类型脑损伤主要见于足月儿脑瘫,未成熟儿少见。结论颅脑MRI表现与脑瘫的类型、出生胎龄密切相关。

关键词：脑性瘫痪磁共振出生胎龄

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早产儿视网膜病的前瞻性多中心流行病学研究

早产儿视网膜病的前瞻性多中心流行病学研究

给予未成熟儿较好的护理是否会影响其肺功能的远期预后

2012年江浙沪儿科学术年会暨浙江省医学会儿科学分会学术年会、儿内科疾病诊治新进展国家级学习班

作者：周也群石文静陈超复旦大学附属儿科医院新生儿科

目的我国虽早已开展早产儿视网膜病筛查,但筛查现状及ROP流行病学特征尚不清楚,目前仍没有全国性的数据。本文通过多中心合作研究,进行规范的ROP筛查,在较大范围内前瞻性调查我国多家医院新生儿科早产儿视网膜病的发生率,旨在了解我国... 详细信息

目的我国虽早已开展早产儿视网膜病筛查,但筛查现状及ROP流行病学特征尚不清楚,目前仍没有全国性的数据。本文通过多中心合作研究,进行规范的ROP筛查,在较大范围内前瞻性调查我国多家医院新生儿科早产儿视网膜病的发生率,旨在了解我国早产儿视网膜病筛查情况、流行病学特征,为进一步防治提供理论依据。方法选取我国不同地区共17家医院的新生儿科和眼科建立多中心协作网,将2010年6月1日至2012年1月1日在ROP筛查协作单位收治入院的出生体重出生体重儿或出生胎龄出生体重出生体重儿或出生胎龄胎龄的减小而逐渐增高。出生体重2000g为3.19%。ROP发生率随着出生体重减小而逐渐增高。669例ROP患者中,ROP1期423例,占ROP总数的63.22%,ROP2期189例,占ROP总数的28.25%,ROP3期57例,占ROP总数的8.52%,无ROP4-5期。急进型ROP2例,激光或手术治疗者共51例。ROP轻度者占总数的91.48%。ROP重度者占总数的8.52%。其中,华南与西南地区ROP发生率较低,发生率出生体重出生胎龄出生体重与出生胎龄、患儿罹患RDS、呼吸暂停、败血症及感染等疾病及相关治疗措施,其ROP发生率也有相应变化特点。

关键词：早产儿视网膜病低出生体重儿出生胎龄 ROP 复旦大学附属儿科医院新生儿科流行病学研究

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世界核心医学期刊文摘（儿科学分册） 2006年第A10期2卷 13-14页

作者： Halvorsen T. Skadberg B.T. Eide G.E. 李开 Department of Pediatrics Haukeland University Hospital N- 5021BergenNorway

Aims: To assess whether lung function in late childhood had improved in subjects born extremely prematurely in the early 1990s compared to the early 1980s, and whether neonatal factors in the respective periods had different impact on long- term pulmonary outcome. Design: Population- based, controlled cohort study. Lung function was determined in 81 of 86 (94% ) eligible subjects born with gestational age ≤ 28 weeks or birthweight ≤ 1000 g in Western Norway in 1982- 85 (n = 46) and 1991- 92 (n = 35), and in 81 matched control subjects born at term. Results: The incidence of bronchopulmonary dysplasia was similar in the two periods. At follow- up, airway obstruction, hyper- responsiveness and pulmonary hyperinflation were similarly increased in both preterm cohorts compared to matched controls. Furthermore, current lung function was similarly related to neonatal respiratory disease in both birth- cohorts: FEV1 was reduced with respectively 18.6% and 18.7% of predicted in preterms dependent on supplemental oxygen at 36 weeks postmenstrual age. Lack of antenatal treatment with corticosteroids and prolonged neonatal oxygen treatment predicted similar significant airway obstruction in the two birth- cohorts Conclusion: Preterms born in different eras of neonatology had similar long- term decreases in lung function. Long periods of oxygen supplementation are still required to salvage immature infants, and airway obstruction may still be a common longterm outcome.

关键词：未成熟儿充气过度受试组氧疗时间出生胎龄队列研究气道阻塞皮质激素类药物生者呼吸系统疾