摘要目的 探讨双胎早产儿的临床特点,为今后临床工作提供指导.方法 采用回顾性分析方法,收集2010年6月至2012年6月在昆明医科大学第一附属医院儿科住院的593例早产儿的临床资料,包括胎龄、出生体质量及并发症等,并将593例早产儿分为2组:131例双胎早产儿为研究组,462例单胎早产儿为对照组.研究组根据分娩顺序分为大双组(64例)和小双组(67例).对各组早产儿临床资料进行统计学分析.结果 对照组早产儿胎龄为(34.23±1.90)周,研究组早产儿胎龄为(33.91 ±1.82)周,2组比较差异无统计学意义(t=1.689,P=0.092).研究组早产儿出生体质量[(1 921.64 ±414.05)g]与对照组[(2 164.98±495.85)g]比较差异有统计学意义(f=-5.209,P =0.000).研究组胎膜早破的发病率为16.79％(22/131例),对照组为32.68％(151/462例),2组比较差异有统计学意义(x2=12.472,P =0.000);研究组新生儿窒息的发病率为9.92％(13/131例),对照组为17.10％(79/462例),2组比较差异有统计学意义(x2=4.010,P=0.045);研究组呼吸窘迫综合征的发病率为6.87％(9/131例),对照组为3.03％(14/462例),2组比较差异有统计学意义(x2 =4.037,P =0.045);研究组呼吸暂停的发病率为4.58％(6/131例),对照组为0.65％(3/462例),2组比较差异有统计学意义(x2=8.085,P=0.004);研究组胎粪吸入综合征的发病率为0,对照组为3.90％(18/462例),2组比较差异有统计学意义(P=0.018);研究组新生儿低血糖症的发病率为27.48％(36/131例),对照组为16.67％(77/462例),2组比较差异有统计学意义(x2=7.738,P=0.005);研究组新生儿脓毒症的发病率为16.79％(22/131例),对照组为8.44％(39/462例),2组比较差异有统计学意义(x2=7.715,P =0.005);研究组宫外生长发育迟缓的发病率为6.10％(8/131例),对照组为2.38％(11/462例),2组比较差异有统计学意义(x2 =4.568,P=0.033).研究组中,大双组脓毒症的发病率为29.68％(19/64例),小双组为14.93％(10/67例),2组比较差异有统计学意义(x2 =4.138,P =0.042);大双组与小双组其他并发症比较差异均无统计学意义.结论 双胎早产儿在新生儿期出现呼吸窘迫综合征、呼吸暂停、新生儿低血糖症、脓毒症及宫外生长发育迟缓的发病率较单胎早产儿高,胎粪吸入综合征的发病率则以单胎早产儿发生率较高.

abstractsObjective To explore the clinical characteristics in twin premature infants in order to provide some guidance for clinical work in future.Methods The clinical data of 593 premature infants hospitalized in Department of Pediatrics,the Affiliated Hospital of Kunming Medical University were collected from June 2010 to June 2012,in terms of gestational age,birth weight and neonatal complications.A retrospective analysis was performed for the data.The premature infants were divided into 2 groups:study group of 131 twin premature infants and control group of 462 singleton premature infants.The 131 twin premature infants in study group were divided into large double group(n =64) and small double group(n =67) according to delivery time.The clinical data of premature infants in each group were statistically analyzed.Results The gestational age of study group was (34.23 ± 1.90) weeks,which in control group was (33.91 ± 1.82) weeks,and there was no significant difference between the 2 groups(t =1.689,P =0.092).The birth weight in study group [(1 921.64 ± 414.05)g] had statistically significant difference compared with control group [(2 164.98 ± 495.85) g] (t =-5.209,P =0.000).The study group of incidence of premature rupture of membranes was 16.79％ (22/131 cases)and which in the control group was 32.68％ (151/462 cases),and there was statistically significant difference between the 2 groups (x2 =12.472,P =0.000) ;the incidence of neonatal asphyxia of study group was 9.92％ (13/131 cases) and that of the control group was 17.10％ (79/462 cases),there was statistically significant difference between the 2 groups (x2 =4.010,P =0.045) ; the incidence of respiratory distress syndrome in study group was 6.87％ (9/131 cases) and that in the control group was 3.03 ％ (14/462 cases),the difference was statistically significant between the 2 groups (x2 =4.037,P =0.045) ; the incidence of apnea in study group was 4.58％ (6/131 cases) and that in the control group was 0.65％ (3/462 cases),the difference was statistically significant between the 2 groups(x2 =8.085,P =0.004) ; the incidence of meconium aspiration syndrome of study group was 0 and that of the control group was 3.90％ (18/462 cases),there was statistically significant difference (P =0.018) ;the incidence of neonatal hypoglycemia of study group was 27.48％ (36/131 cases) and that of the control group was 16.67％ (77/462 cases),the difference was statistically significant between the 2 groups (x2 =7.738,P =0.005) ;the incidence of sepsis of study group [16.79％ (22/131 cases)] was significantly higher than that of the control group [8.44％ (39/462 cases)],and the difference was statistically significant between the 2 groups (x2 =7.715,P =0.005) ;the incidence of extrauterine growth retardation of study group was 6.10％ (8/131 cases) and that of the control group was 2.38％ (11/462 cases),the difference was statistically significant between the both groups (x2 =4.568,P =0.033).In the study group,the incidence of neonatal sepsis in big double group was 29.68％ (19/64 cases),and that in small double was 14.93％ (10/67 cases),there was statistically significant difference between the 2 groups(x2 =4.138,P =0.042).The other complications between the big double group and small double group had no significant difference.Conclusions The incidence rates of acute respiratory distress syndrome,apnea,neonatal hypoglycemia,sepsis and extrauterine growth retardation of twin premature infants are higher than the singleton premature infants in the neonatal period.But the incidence rate of meconium aspiration syndrome is a higher in singleton premature infants.