| Bacground:The preturm infant is a special group in neonates, characteristic of high morbidity and mortality rate, poor prognosis and heavy disease burden. It is an important part in the perinatal medical research. The incidence of preturm infant in China is 5%～10%, which is increasing year by year. With the constantly changing and developing of perinatal medieine, the composition of hospitalized neonatal infants, disease spectrum, treatment and care routines are changed. All of these have made new demands on the doctor's concepts and techniques of medical treatment. We need to analysis the basic clinical data to get the basic rules guiding clinical practice and decision, so to provide the children with better medical services.At present, the clinical medicine model in China lags behind, the experience medicine model is still dominated medical model. thoes reaches that directly targeting children, with strong evidence, multi-center, prospective, descriptive, or interventive are also less.Objective:By systematicly reviewing the medical records of hospitalized preterm infants in the First Hospital of Jilin University from 2004 to 2009 to guide clinical decision making and provide patients with better health care services; and to awareness the overall level on preterm children in our hospital; Laid the groundwork for a deeper study of single disease and to fill gaps of long-term, systematic and integrated epidemiological studies on premature children.Methods:Design and fill the " questionaire of preturm infants ", the questionaire included general informations (date of birth, age, gender, gestational age, birth weight, discharge weight, length of stay), common complications of preterm (asphyxia, NRDS, pneumonia, CLD, PDA, jaundice, purulent meningitis, sepsis, NEC, intracranial hemorrhage, ROP), therapy (PS and PICC applications), and prognosis (survival, death and give up). the subjects are preturm infants hospitalized in the NICU who were born from the January 1, 2004 to December 31, 2009, excluding hospital days>28 days and those with serious deficiencies in clinical data. All datas collected to create data files in Excel sheets and using the SPSS 13.5 statistical software for processing.Result:1. A total of 3468 cases of hospitalized patients diagnosed as preturm infant, and 3256 cases meet the inclusion criteria . The mean gestational age was 33.36±2.39 weeks, mean birth weight was 2004.47±556.32g, male to female ratio was 1.77:1.2. From 2004 to 2009, the number of hospitalized preterm infants were 184 cases, 248 cases, 323 cases, 622 cases, 857 cases, 1022 cases separately, showed an increasing trend year by year. In 2004 to 2006, the number of cases in gestational age <30 weeks, 30 weeks～and34 weeks～group were 44 cases, 288 cases, 421 cases, with percentage of 5.84%, 38.25% and 55.91% in the preterm children hospitalized on same period.In 2007 to 2009, the number of cases in gestational age <30 weeks, 30 weeks～and34 weeks～group were 189cases, 1062 cases, 1245 cases, with percentage of 5.84%, 38.25% and 55.91% in the preterm children hospitalized on same period. Compared to the previous 3 years ,number of patients in each group in the second 3 years were increased. The proportion of patients in gestational age <30 weeks and 30 weeks～groups were increased but the proportion of 34 weeks～group was reduced. In 2004 to 2006, the number of cases in birth weight <1000g,,1000g～,1500g～and 2500g～groups were 5 cases,115 cases, 442 cases, 153 cases,with percentage of 0.70%, 16.08%, 61.82% and 21.40% in the preterm children hospitalized on same period. In 2007 to 2009, 48 cases,369 cases,1600 cases and 534 cases separately,with percentage of 1.88%,14.46%,62.72% and 20.93%. the number of patients in each group were increased in the second 3 years, compared with the previous 3 years.3. The male to femal ratio was no significant change with the gestational age changing, but the male to femal ratio was gradually increased with birth weight changing.4. The weight increase percentage from 2004 to 2009 were 2.81%, 1.34%, 4.71%, 3.43%, 5.28%, 5.28% respectively; the average length of stay was 10.70±10.29 days, 10.94±9.70 days, 13.19±10.77 days, 14.89±12.09 days, 17.62±17.08 days and 19.06±14.76 days and overall average length of stay was 17.12±14.24 days, are rising year by year.5. The most common complications in hospitalized preturm infants were pneumonia (35.72%), jaundice (23%), septicemia (11.12%), asphyxia (8.29%), NRDS (7.89%), PDA (6.54%) intracranial hemorrhage (6.2%), ROP (4.7%), purulent meningitis (3.29%), NEC (1.23%), CLD (0.92%). The incidence of diferent complications showed different trend year by year. In addition to jaundice , incidence rate of other common complication wre decreased with the gestational age and birth weight increased. There were high incidences of pneumonia and jaundice in the boys, and PDA was higher in the girls. The incidences of Asphyxia, NRDS, pneumonia, PDA, sepsis, NEC, intracranial hemorrhage, ROP and CLD was negatively correlated with gestational age and birth weight. The incidence of Jaundice was not associated with gestational age, but positively correlated with birth weight. The incidence of purulent meningitis was negatively correlated with birth weight but there was no correlation with gestational age.6. In 2004 ~ 2009, PS application rates were 0.57%, 2.56%, 2.27%, 3.29%, 6.59%, 8.62%, increasing year by year, and the smaller the gestational age and birth weight the higher application rate .The total application rate was 5.56%.The survival was higher in NRDS treated with PS than those untreated with PS.The PICC application rate in 2009 was 6.64%, and used more in the small gestational age and low birth weight infants.7. In 2004 ~ 2009, the total survival rate of hospitalized premature children was 86.00%. In 2004 to 2006, gestational age <30 weeks, 30 weeks～and 34 weeks～groups and overall survival rates were 45.45%, 76.74%, 90.02% and 82.34%. In 2007 to 2009 the survival rates in the same gestational age groups were 54.50%, 86.16% 92.85% and 87.10%; Compared to the first 3 years, the number of survival cases and survival rates in each group were increased than the second 3 years. In 2004 to 2006,the survival rates in birth weight <1000g, 1000g ~, 1500g ~, 2500g ~ groups and overall were 20.00%, 58.26%, 85.97%, 92.16 and 82.38%.In 2007 to 2009, survival rates were 41.67%, 71.00%, 90.88%, 76.59% and 84.04%. Compared to the first 3 years,the survival number of patients in each group increased. Survival rate in the <1000g, 1000g ~, 1500g ~ groups and overall increased, but in 2500g ~ group decreased. There was no different on survival rate between male and female infants.Conclusion: 1.The number of hospitalized preturm infants in The First Hospital of Jilin University in 2004 to 2009 increases year by year. Compared to the first 3 years,the proportion of hospitalized premature children in the gestational age <34 weeks groups was significant increase in the second 3 years.2.The male to female ratio was 1.77:1. There were high incidences of pneumonia and jaundice in the boys, and the PDA incidences wer ehigher in the girls.3.The first five common complications in hospitalized preturm infants were pneumonia, jaundice, septicemia, asphyxia and NRDS. The incidence of diferent complications showed different trend year by year.The incidences of Asphyxia, NRDS, pneumonia, PDA, sepsis, NEC, intracranial hemorrhage, ROP and CLD were negatively correlated with gestational age and birth weight. The incidence of Jaundice was not associated with gestational age, but positively correlated with birth weight. The incidence of purulent meningitis was negatively correlated with birth weight but there was no correlation with gestational age.4. The weight increase percentage and the average length of stay from 2004 to 2009 were rising year by year.5. In 2004 ~ 2009, the total survival rate of hospitalized premature children was 86.00%. Survival rates in gestational age<30 weeks, 30 weeks～,34 weeks～groups were 54.50%, 86.16% 92.85% and 87.10%, birth weight <1000g, 1000g ~, 1500g ~, 2500g ~ group were 39.62%, 67.98%, 89.81% and 80.06% respectively. Compared to the first 3 years,the survival number of patients in each group increased. Survival rate in every gestational age group and birth weight<2500g ~ groups increased, but in 2500g ~ group decreased in the second 3 years. |
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