目的 分析超早产儿支气管肺发育不良(BPD)的影响因素,以期为BPD的防治提供依据。方法 对2012年1月－2017年12月安徽省妇幼保健院新生儿重症监护病房收治的生后24 h入院胎龄<28周且存活≥28 d的102例超早产儿的住院资料进行回顾性调查,根据BPD诊断标准分为BPD组(n=77)和非BPD组(n=25)。结果 102例超早产儿,发生BPD者77例(75.5％)。单因素分析结果显示男性、胎龄、出生体重、住院天数、母亲绒毛膜羊膜炎、早发型败血症、早产儿视网膜病、肺动脉高压、总有创机械通气时间、总用氧时间与超早产儿发生BPD相关(P＜0.05)。多因素Logistic回归显示肺动脉高压(OR＝25.595,95%CI:1.155~567.379),总用氧时间(OR＝1.676,95%CI:1.250~1.893)是超早产儿发生BPD的独立危险因素。结论 超早产儿的BPD发生率较高,降低肺动脉压力、减少用氧时间,且在早期采用全面和标准化的治疗方法可以减少BPD的发病率。
Abstract
Objective To explore the risk factors of bronchopulmonary dysplasia(BPD) in extremely preterm infants,in order to provide reference for the prevention and treatment of BPD. Methods Clinical data in 102 extremely preterm infants in neonatal intensive care unit(NICU) were collected and retrospectively analyzed,who were admitted in Maternal and Child Health Hospital of Anhui Province at 24 hours after birth from January 2012 to December 2017,with gestational age less than 28 weeks and survived 28 days after birth.According to the diagnosis standard of BPD,these infants were divided into BPD group(n=77) and non BPD group(n=25). Results Among 102 extremely preterm infants,77(75.5％) cases developed BPD.Univariate analysis Results showed that male,gestational age,birth weight,days in hospital,maternal chorioamnionitis,early-onset neonatal sepsis,retinopathy of prematurity,pulmonary hypertension,the time of invasive mechanical ventilation,the duration of oxygen therapy were associated with the BPD occurrence in extremely preterm infants.Multivariate Logistic regression analysis indicated that pulmonary hypertension(OR=25.595,95%CI:1.155-567.379) and the duration of oxygen therapy(OR=1.676,95%CI:1.250-1.893) were the independent factors of BPD occurrence in extremely preterm infants. Conclusions The prevalence of BPD which can be influenced by many factors is really high in extremely preterm infants.Lowering pulmonary artery pressure,shortening the duration of oxygen therapy and adopting a comprehensive and standardized treatment at an early stage may decrease the development of BPD.
关键词
支气管肺发育不良 /
超早产 /
危险因素
Key words
bronchopulmonary dysplasia /
extremely premature /
risk factors
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