极低体质量近存活期分娩儿一例的出生后早期管理

近存活期分娩（PVB）儿各组织系统发育极不成熟，易发生各种器官功能损害和并发症，预后常不佳。目前关于PVB儿出生后早期管理的报道不多，诸多尚待解决的问题仍是围产医学所面临的挑战。经有效的新生儿复苏和呼吸循环支持、积极的营养支持和喂养、防治感染、内分泌和代谢性疾病管理、积极处理早产儿相关并发症，以及发育支持护理、家庭参与式护理等一系列个体化管理和精细化护理，四川省医学科学院·四川省人民医院成功救治了1例胎龄23周，出生体质量（BW）为450 g的PVB儿。本文通过总结1例PVB儿的出生后早期管理，并结合文献复习进行归纳总结，以期为提高BW<500 g的PVB儿存活率并获得良好预后提供经验及借鉴。

Early Postnatal Management of an Extremely Low Birth Weight Periviable Infant

Periviable neonates have been implicated in a higher incidence of multi-organ injuries and complications due to the extreme prematurity, which is usually associated with poor prognosis. To date, postnatal management of periviable neonates remains one of the most challenging issues, and has been reported by limited studies. By individualized treatment and intensive care, including effective resuscitation, respiratory and circulatory support, active nutritional support and feeding, prevention and treatment of infection, management of endocrine and metabolic problems, management of preterm-related complications, and individualized nursing such as developmentally supportive care and family integrated care, a periviable baby with gestational age of 230/7 weeks and birth weight of 450 g was successfully rescued by Sichuan Academy of Medical Sciences· Sichuan Provincial People's Hospital. We summarized early postnatal management of this periviable baby and reviewing relevant literature, aiming at providing evidence for improving the survival and prognosis of periviable babies with birth weight <500 g.