Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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초극소 저출생 체중아의 최근 치료 성적 - CRIB(clinical risk index for babies) II 점수를 이용한 생존율 분석 -

Recent outcome of extremely low birth weight infants - The use of CRIB(clinical risk index for babies) II score for analyzing the survival rate -

  • 김도현 (서울대학교 의과대학 소아과학교실) ;
  • 심소연 (가천의과대학교 길병원 소아과) ;
  • 김재리 (서울대학교 의과대학 소아과학교실) ;
  • 신승한 (서울대학교 의과대학 소아과학교실) ;
  • 김은선 (서울대학교 의과대학 소아과학교실) ;
  • 정경은 (서울대학교 의과대학 소아과학교실) ;
  • 김상덕 (서울대학교 의과대학 소아과학교실) ;
  • 이진아 (서울대학교 보라매병원 소아과) ;
  • 최창원 (서울대학교 의과대학 소아과학교실) ;
  • 김이경 (서울대학교 의과대학 소아과학교실) ;
  • 김한석 (서울대학교 의과대학 소아과학교실) ;
  • 김병일 (서울대학교 의과대학 소아과학교실) ;
  • 최중환 (서울대학교 의과대학 소아과학교실)
  • Kim, Do-Hyeon (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Shim, So-Yeon (Department of Pediatrics, Gil Medical Center, Gacheon Medical School) ;
  • Kim, Jae-Ri (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Shin, Seung-Han (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Eun Sun (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Joung, Kyoung-Eun (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Sang Duk (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Lee, Jin A (Department of Pediatrics, Boramae Hospital, Seoul National University) ;
  • Choi, Chang Won (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Ee-Kyung (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Han-Suk (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Kim, Beyong Il (Departments of Pediatrics, College of Medicine, Seoul National University) ;
  • Choi, Jung-Hwan (Departments of Pediatrics, College of Medicine, Seoul National University)
  • 투고 : 2006.05.24
  • 심사 : 2006.07.05
  • 발행 : 2006.09.15
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초록

목 적 : 최근 들어 출생체중 1,000 g 미만으로 태어난 ELBWI의 생존율은 주산의학 및 신생아학의 발달로 인해 증가하고 있다. 저자들은 최근 6년간 서울대학교병원에서 태어난 ELBWI의 생존율 변화를 분석하여 신생아 집중 치료술의 향상여부를 알고자 하였다. 방 법 : 본 연구에 포함된 99명의 ELBWI은 출생 년도에 따라 세 시기(I기 : 2000-2001년, II기 : 2002-2003년, III기 : 2004-2005년)로 나누어졌다. 세 시기의 임상적 중증도를 보정하기 위해 CRIB II 점수 체계를 이용하여 ELBWI의 생존율을 비교하였다. 결 과 : ELBWI의 전체 생존율은 74.7%였고, 세 시기에 걸쳐 생존율은 지속적으로 향상되었다(I기 : 60.7%, II기 : 73.3%, III기 : 85.3%). 최소한 50% 이상이 생존하는 것으로 정의된 생존한계는 출생체중 600 g대, 재태기간 25주였다. 출생체중 750 g 미만인 경우에는 세 시기에 걸쳐 생존율이 전체 생존율에 비해서 매우 두드러지게 증가하였다(I기 : 10%, II기 : 46.2%, III기 : 70.6%). ELBWI의 세 시기에 걸친 지속적인 생존율 향상은 CRIB II 점수로 보정한 후에는 더 뚜렷해졌다. 결 론 : 본 기관에서 최근 6년간에 걸친 ELBWI의 생존율은 지속적으로 향상되는 경향을 보였고, 이러한 경향은 특히 출생체중 750 g 이하에서 두드러졌다. 이러한 생존율 향상은 ELBWI의 임상적 중증도 개선과는 상관없이 이루어졌다.

Purpose : The survival rate of infants weighing less than 1,000 g at birth(extremely low birth weight infants, ELBWI) has increased due to recent advances in perinatal and neonatal intensive care. The purpose of this study was to evaluate the survival rates of ELBWI born at Seoul National University Hospital during the last six years. Methods : A total of 99 infants were divided into three groups(period I: 2000 to 2001, period II: 2002 to 2003, period III : 2004 to 2005) based on date of birth. We compared the survival rate of ELBWI over the three periods, using CRIB II score for adjustment for clinical severity. Results : Overall survival rate of ELBWI was 74.7 percent. The survival rate of ELBWI increased over the three periods(period I: 60.7 percent, period II : 73.3 percent, period III : 85.3 percent). The threshold of viability(defined as survival of at least 50 percent of infants) was 25 weeks of gestation and 600 g at birth. The birth weight-specific survival rates increased considerably over the three periods for infants <750 g at birth(period I: 10 percent, period II: 46.2 percent, period III : 70.6 percent). The survival rates of ELBWI over the three periods increased much remarkably after adjustment for clinical severity by CRIB II score. Conclusion : In our institution, survival rates of ELBWI during the last six years continued to improve, particularly for infants weighing <750 g at birth. This increase in survival rates was not associated with the clinical severity of ELBWI.

키워드

참고문헌

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