贵州医科大学学报

2019, v.44;No.221(02) 213-217

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早产儿支气管肺发育不良发病影响因素分析
Clinical Analysis of Premature Infants with Bronchopulmonary Dysplasia

张敏,刘禹江,陈晓霞
ZHANG Min,LIU Yujiang,CHEN Xiaoxia

摘要(Abstract):

目的:分析早产儿支气管肺发育不良(BPD)发病影响因素。方法:新生儿科胎龄<37周且住院时间≥28 d的早产儿164例,根据出生后持续用氧≥28 d诊断为BPD,164例早产儿分为BPD组(根据病情分为轻度及中重度BPD组)和非BPD组,分析不同胎龄、体质量早产儿BPD发生率,比较BPD组患儿及非BPD组早产儿、轻度及中重度BPD患儿的一般资料、围产期资料及治疗资料等,将差异有统计学意义的指标进行多因素Lo-gistic回归分析,观察患儿发生BPD的影响因素。结果:确诊BPD 54例早产儿中,胎龄<32周早产儿比例为85. 18%,体质量<1 500 g的早产儿比例为66. 67%; BPD组患儿胎龄、体质量低于非BPD组,试管婴儿、5 minApgar评分<8分、发生呼吸窘迫综合征(RDS)比例、肺部感染、肺出血、肺泡表面活性物质(PS)使用、无创通气、有创通气早产儿比例及输血量高于于非BPD组,差异有统计学意义(P <0. 05); Logistic回归分析显示,合并RDS、有创通气≥7 d为发生BPD的独立危险因素;轻度BPD组患儿胎膜早破史比例、败血症比例、输血次数、输血量、机械通气时间低于中重度BPD组(P <0. 05)。结论:胎龄32周以下、体质量<1 500 g的早产儿BPD的发生率较高,合并RDS、有创通气≥7 d为发生BPD的独立危险因素。
Objective: To investigate the risk factors of bronchopulmonary dysplasia( BPD) in preterm infants. Methods: The clinical data of premature infants with gestational age < 37 weeks and stay longer than 28 days in Pediatrics Department were analyzed retrospectively. According to the continuous use of oxygen ≥28 days after birth as standard,the 164 infants were divided into mild BPD group,moderate and severe BPD group according to the grading standard as well as non-BPD group. Incidence rate of premature infants BPD were analyzed from gestational age and body mass; comparing general information,perinatal period data and treatment data of premature infants from BPD group and non-BPD groups,as well as the three BPD groups; significant indexes were to be analyzed by multifactors Logistic regression analysis to detect risk factors of BPD incidence. Results: Premature infants with gestational age less than 32 weeks accounted for 85. 18% out of 54 diagnosed cases,and body mass less than 1500 g infants accounted for 666. 67%. The gestational age and body mass of BPD group infants were lower than non-BPD group; tube baby,5 min Apgar score < 8,RDS proportion,pulmonary infection,pulmonary hemorrhage,PS utilizing,NIPPV,IPPV premature infants proportion and blood transfusion volume were all higher than non-BPD group,differences were statistical significant( P < 0. 05). Logistic regression analysis showed that combined RDS and IPPV≥ 7 days were independent risk factors of BPD; There were significant differences in the history of premature rupture of membranes,septicemia,blood transfusion times,blood transfusion volume and mechanical ventilation time between mild BPD group and moderate/severe BPD group( P < 0. 05). Conclusion: 1. The incidence rate of BPD in premature infants with gestational age of less than 32 weeks and less than 1500 g was higher. Combined RDS and invasive ventilation more than 7 days were the risk factors of BPD.

关键词(KeyWords): 早产儿;支气管肺发育不良;机械通气;肺部感染;高危因素
premature infant;bronchopulmonary dysplasia;mechanical ventilation;pulmonary infection;risk factors

Abstract:

Keywords:

基金项目(Foundation): 贵州省科学技术基金资助项目[黔科合J字(2010)2166号]

作者(Author): 张敏,刘禹江,陈晓霞
ZHANG Min,LIU Yujiang,CHEN Xiaoxia

DOI: 10.19367/j.cnki.1000-2707.2019.02.018

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