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find Keyword "早产" 159 results
  • 重症极低出生体质量早产儿动脉导管结扎治疗

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  • Early Outcome of Open Heart Surgery for Congenital Heart Diseases in Low Birth Weight Infants and Premature Infants

    Abstract: Objective To analyze the early outcomes of open heart surgery for congenital heart diseases in sixty low birth weight infants and premature infants. Methods Sixty low birth weight infants (body weight<2 500 g) and premature infants with congenital heart diseases undergoing surgical repair from May 2003 to October 2011 were studied retrospectively in Guangdong Cardiovascular Institute. There were 43 male patients and 17 female patients with their mean gestational age of 33.5±4.1 weeks (ranging from 26 to 42 weeks) and mean age at operation of 24.9±12.5 d(ranging from 4 to 55 d). Among them there were 47 premature infants with their mean birth weight of 1 729.3±522.5 g(ranging from 640 to 2 500 g)and mean weight at operation of 1 953.2±463.6 g (ranging from 650 to 2 712 g). All the patients received preoperative treatment in newborn intensive care unit(NICU) and underwent surgical repair under general anesthesia, including 29 patients without cardiopulmonary bypass (CPB)and 31 patients with CPB . All surviving patients received postoperative monitoring and treatment in NICU, and their postoperative complications and in-hospital death were reported. Results A total of 13 patients died during hospitalization with a total in-hospital mortality of 21.7%(13/60), including 4 intra-operative deaths, 6 early deaths (within 72 h postoperatively) and 3 patients giving up postoperative treatment. CPB time was 121.0±74.7 min, aortic clamp time was 74.8±44.7 min, and postoperative mechanicalventilation time was (136.9±138.1)h. Thirteen patients underwent delayed sternal closure. Eight patients underwentreexploation for postoperative bleeding. Ten patients had severe pneumonia, 2 patients had pulmonary hypertensive crisis, and 8 patients had low cardiac output syndrome. All the postoperative complications were resolved or improved after proper treatment. Follow-up was complete in 47 patients from 2 to 12 monthes, and all the patients were alive during follow-up. Conclusion Early surgical repair for low birth weight infants and premature infants with congenital heart diseases is safe and effective.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • 出生体重1500~1999 g早产儿的早产儿视网膜病变筛查结果分析

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Safety of inhalation anesthesia in preterm children of different corrected gestational ages undergoing ocular fundus examination

    Objective To observe the systemic inhalation anesthetic effects of preterm children with different gestational ages under ocular fundus examination, and to assess its safety. Methods Fifty-one preterm children with retinopathy of prematurity (ROP) were included in the study. These kids were divided into 2 groups, group Ⅰ included 24 kids with a corrected gestational age of 33 to <44 weeks, and group Ⅱ included 27 kids with a corrected gestational age of 44 to 64 weeks. The preterm months were same (t=-1.3.P>0.05), but the body weights were different (t=-10.5.P<0.05) between these two groups. Anesthesia was induced by inhalation of 6% sevoflurane, and the period from the beginning of inhalation to disappearance of body movement was the induction time. 6% sevoflurane was inhaled continuously for another period of the induction time, and then the concentration of sevoflurane was adjusted to a maintenance concentration. The initial maintenance concentration was 3%, and was adjusted by 0.5% each time. Sequential method was used to determine the subsequent maintenance concentration. If the preceding patient had not moved during the maintenance period, the sevoflurane concentration was decreased by 0.5% for the next patient. If the preceding patient had moved during the maintenance period, the sevoflurane concentration was increased by 0.5% for the next patient. Respiratory depression and cough during the induction and maintenance period, duration of anesthesia and recovery time were recorded. Choking and vomiting during drinking or milk-feeding in one hour after the ocular fundus examination were also recorded. Results The effective inhale concentration in 50% patient of sevoflurane was 2.5% in group Ⅰ, 2.9% in group Ⅱ. The average maintenance concentration was (2.5plusmn;0.5)% in group Ⅰ, (3.0plusmn;0.5)% in group Ⅱ. The difference was statistically significant (t=-3.3.P<0.05). The average duration of anesthesia and the average awake time were the same (t=0.04 and -1.0 respectively.P>0.05) between these two groups. The average induction time was significantly shorter in group Ⅰ than in group Ⅱ, the difference was statistically significant (t=-4.9.P<0.05). All patients were successfully completed the ocular examination. No respiratory depression or cough occurred during and after the examination. No choking and vomiting during drinking or milkfeeding in one hour after the ocular fundus examination. Conclusion Anesthesia with inhaled sevoflurane by a face mask is safe for preterm outpatients undergoing fundus examination.

    Release date:2016-09-02 05:22 Export PDF Favorites Scan
  • Clinical analysis of retinal hemorrhages in high-risk infants

    Objective To investigate the related factors of the retinal hemorrhage in high-risk infants (HRI). Methods Eight hundred and sixty HRI with histories of high-risk pregnancy and/or neonatal asphyxia after 1-5 days of birth were enrolled in this study.In 860 cases of HRI, 498 infants were vaginal delivery and 362 infants were delivered through cesarean sections. Among 498 vaginal delivered infants, 407 infants were eutocia and 91 infants were with forceps delivery; 298 infants were born following normal labor, 102 infants experienced prolonged labor, and 98 infants were urgent birth. The retinal hemorrhages were observed and conditions were graded into three degrees of Ⅰ, Ⅱ, and Ⅲ. Conditions of neonatal asphyxia were evaluated based on criteria of Apgar score. The incidence of retinal hemorrhage in the different types of deliveries and labor processes were compared, and the relationship between degree of retinal hemorrhage and grade of neonatal asphyxia were analyzed. Results In 860 cases of HRI, retinal hemorrhages were found in 202 infants (23.5%). Within these 202 infants, 75 infants (37.1%) were Ⅰ degree retinal hemorrhage, 75 infants (37.1%) were Ⅱ degree retinal hemorrhage, and 52 infants (25.8%) were Ⅲ degree retinal hemorrhage. In these 202 infants of retinal hemorrhage, 172 infants (85.1%) had histories of asphyxia; 119 infants (69.2%) were graded as mild asphyxia-risk, and 53 infants (30.8%) were graded as severe asphyxiarisk. There was a statistical difference of the degree of the retinal hemorrhage between the mild and severe asphyxia-risk infants (chi;2=34.61,P<0.01). The incidence of retinal hemorrhage after vaginal delivery was higher than cesarean section delivery with significant statistical difference (chi;2=30.73,P<0.01). The incidence of retinal hemorrhage after forceps delivery was significantly higher than eutocia with statistical difference (chi;2=62.78,P<0.01). Both prolonged and urgent childbirth had statistically significant higher incidences of retinal hemorrhage compared to normal labor in the process of vaginal delivery (chi;2=45.86, 71.51; P<0.01). Asphyxia, types of delivery, prolonged and urgent labors were risk factors of retinal hemorrhage for HRI (r=7.46,4.87,15.03,6.47;P<0.01). Conclusions The incidence of retinal hemorrhage in high-risk infant was 23.5%. And, asphyxia, types of delivery, prolonged and urgent labors may play roles of risk factor in retinal hemorrhage of HRI.

    Release date:2016-09-02 05:26 Export PDF Favorites Scan
  • 促红细胞生成素与早产儿视网膜病变

      促红细胞生成素(EPO)是一种促造血糖蛋白激素,具有促造血、神经保护与神经再生、促血管生长、促视网膜生存、促进肿瘤生长等生物学特性,可以促进氧诱导视网膜病变模型小鼠新生血管形成,在早产儿视网膜病变(ROP)临床治疗试验中也显示出一定的应用前景。但ROP是一种多因子疾病,多种因子在其发病中都起到了重要作用,单纯抑制EPO并不能完全抑制ROP的发生;EPO是多效应因子,在促进新生血管形成的同时,也可发挥其抗凋亡保护血管和视网膜神经元的作用,过度抑制会加重遭受缺氧刺激的不成熟视网膜血管和神经元的凋亡。尽管如此,进一步加强EPO与ROP相互关系研究,仍然可能会为ROP的治疗研究开辟新的思路。

    Release date:2016-09-02 05:37 Export PDF Favorites Scan
  • 深圳市早产儿视网膜病变激光光凝治疗效果观察及围手术期管理模式探讨

    Release date:2016-09-02 05:41 Export PDF Favorites Scan
  • 广东省部分三级医院早产儿视网膜病变发生率调查

    Release date:2016-09-02 05:41 Export PDF Favorites Scan
  • Analysis on factors influencing for results of laser treatment of zone one retinopathy of premature

    Objective To observe the factors influencing for results of laser treatment of zone one retinopathy of premature(ROP). Methods  The clinical data of 35 patients(69 eyes)with ROP in zone one who diagnosed by examination of indirect ophthalmoscopy were retrospectively analyzed. The eyes were divided into anterior zone one(49 eyes )and posterior zone one(20 eyes). The 69 eyes, aggressive posterior ROP(AP-ROP)in 12 eyes, anterior zone one in four eyes and posterior zone one in eight eyes. The laser photocoagulation of diode indirect ophthalmoscopy with +20 D lens and sclera compressor were used to entire avascular retina. Followup ranged from two to 48 months with the mean of (10.85plusmn;11.35 )months. Take the cristae fadeaway and stable condition as cure; retinopathy proceed to the stage 4 and 5 ROP as retinopathy progress. Results  Forty-two out of 69 eyes (60.87%) were cured and retinopathy progress in 27 eyes (39.13%). Thirty-four out of 49 eyes (69.38%) with anterior zone one were cured and retinopathy progress in 15 eyes (30.61%); eight out of 20 eyes (40.00%) with posterior zone one were cured and retinopathy progress in 12 eyes (60.00%). The difference of progress rate between anterior and posterior zone one was statistically significant(chi;2=5.15, P<0.05).Conclusions Laser photocoagulation is effective for treatment of zone one ROP, the prognosis of anterior zone one is better than posterior zone one; retinopathy progress after photocoagulation was associated with extent of fibrovascular organization.

    Release date:2016-09-02 05:40 Export PDF Favorites Scan
  • Clinical study on the effect of polycythemia on retinopathy of prematurity

    Objective To explore the effect of polycythemia on retinopathy of prematurity (ROP). Methods The clinical data of 262 premature cases was analyzed retrospectively in Xi'an Children Hospital from January 2005 to January 2009. Polycythemia was found in 46 cases (17.56%), including 27 males and 19 females. In 216 infants without polycythemia (82.46%), 155 were male and 61 were female. The difference of the birth weight (t=0.730, P=0.466), gestational age (t=1.603,P=0.110), oxygen inhalation numbers (chi;2=0.04,P>0.90) and times (t=1.225,P=0.223), and concentration (t=1.823,P=0.071) between polycythemia group and no polycythemia group were not significant. In order to diagnose ROP, the ocular fundus of all premature infants was examined with binocular indirect ophthalmoscope,and the stage of ROP was assessed.Results In all the premature infants,ROP was found in 120 cases (45.80%). In 46 cases of polycythemia, ROP was found in 25 cases (54.34%); in 216 infants without polycythemia, ROP was found in 95 cases (43.98%); the difference of ROP incidence between the two groups was not significant (chi;2=1.64, Pgt;0.1).In 120 ROP patients, 104 cases (86.67%) with ROP<3 stage and 16 cases (13.33%) with ROP ge;3 stage were found. In 25 ROP patients with polycythemia, 18 cases (72.00%) with ROP <3 stage and 7 cases (28.00%) with ROP ge;3 stage were found. In 95 ROP patients without polycythemia, 86 cases (90.53%) with ROP <3 stage and 9 cases (9.47%) with ROP ge;3 stage were found. The difference of the incidence of ROP <and ge;3 stage between the two group was significant (chi;2=4.38, Plt;0.05). In 120 cases of ROP, prethreshold retinopathy was found in 106 cases (88.33%), while threshold and post-threshold retinopathy was in 14 cases (11.67%). In 25 ROP patients with polycythemia, prethreshold retinopathy was found in 19 cases (76.00%), and threshold and post-threshold retinopathy was in 6 cases (24.00%).In 95 ROP infants without polycythemia, pre-threshold retinopathy was found in 87 cases (91.58%),while threshold and post threshold retinopathy was in 8 cases (8.42%).The difference of the incidence of ROP with prethreshold, and threshold and post-threshold retinopathy between the two groups was not significant (chi;2=3.27,P>0.05).Conclusion Polycythemia may not affect the incidence of ROP,but impact on the severity of ROP.

    Release date:2016-09-02 05:41 Export PDF Favorites Scan
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