ABSTRACT
Objective:To study the current neonatal mortality rate and causes of deaths in Chifeng city to further reduce neonatal mortality.Methods:From 2018 to 2019, neonatal mortality data of Chifeng, Inner Mongolia were reviewed. Neonatal mortality, causes of deaths, the distribution of mortality in different groups of neonates and different tiers of hospitals were analyzed.Results:A total of 172 neonatal deaths were included. The top five causes of deaths were asphyxia (23.8%), respiratory distress syndrome (RDS) (22.7%), severe congenital malformation (18.0%), infection (11.6%) and preterm birth (9.3%). Among the 172 neonates, 61 were full-term (35.5%). The leading causes of deaths were asphyxia (34.4%), severe congenital malformation (32.8%) and RDS (13.1%). 111 were premature infants (64.5%), including 16 infants (14.4%) with gestational age (GA)≤30 weeks died without treatment. The leading causes of deaths in premature infants receiving treatment were RDS (29.7%), asphyxia (18.0%) and infection (15.3%). 124 cases (74.0%) were early neonatal death (END) (death within 7 d after birth). The top 3 causes of END in preterm infants were RDS (43.1%), asphyxia (27.7%) and severe congenital malformations (12.3%). The top 3 causes of END in full-term infants were asphyxia (44.2%), severe congenital malformations (23.3%) and RDS (18.6%). 48 cases (26.0%) were late neonatal death (LND) (death after 7 d of age). The top 3 causes of LDN in preterm infants were infection (33.3%), RDS (10.0%) and severe congenital malformations (10.0%).The top 3 causes of LND in full-term infants were severe congenital malformations (55.6%), asphyxia (11.1%) and genetic diseases (11.1%). Compared with Tier II hospitals, the GA [(33.1±4.2) weeks vs. (35.0±5.1) weeks] and the birth weight (BW) [(2 000±480) g vs. (2 620±515) g] were lower in Tier Ⅲ hospitals ( P<0.05). For full-term infants, the proportion of asphyxia as the cause of deaths in Tier Ⅱ hospitals was significantly higher than Tier Ⅱ hospitals ( P<0.05). Conclusions:Neonatal deaths mainly occur within the first week after birth with asphyxia, prematurity, severe congenital malformations, infection and RDS as the leading causes. The causes of deaths of preterm and full-term infants are different at different postnatal ages. For full-term infants, the incidences of deaths due to asphyxia are higher in Tier Ⅱ hospitals than Tier Ⅲ hospitals.
ABSTRACT
Objective:To evaluate the application of autotransplantation of splenic tissue in clinic.Methods:Serial operations of autoplasty spleen were performed in 32 cases total splenectomy in past ten years.18 original spleens were transplanted into omental bursa,12 into an isolated segment of small intestine,2 into vagina musculi recti abdominis.Results:All cases were cured.Follow-up splenic functions were satisfactory.The transplantation of splenic tissue into an isolated of small intestine was the best.Conclusion:Autotransplantations of splenic tissue are safe and feasible for splenic injure total splenectomy. It can restore the physiological funtions of spleen.