超低/极低出生体重儿支气管肺发育不良的危险因素及肺外合并症分析

Analysis of risk factors on bronchopulmonary dysplasia and its complications of extremely low birth weight infants(ELBWI)and very low birth weight infants

目的探讨超低出生体重儿(extremely low birth weight infant,ELBWI)、极低出生体重儿(very low birth weight infants,VLBWI)支气管肺发育不良(broncho-pulmonary dysplasia,BPD)的相关危险因素及并发症。方法分析2019年1月至2020年1月于我院收治的ELBWI和VLBWI病例资料,按照临床症状分为非BPD组和BPD组。采用独立样本t/χ2检验进行组间比较,多因素logistic回归分析探讨BPD发生的危险因素。结果共140例病例资料纳入研究,ELBWI 10例、VLBWI 130例,非BPD组71例,BPD组69例。两组在胎龄、出生体重、产前足量激素保胎、Apgar评分≤3分、吸氧浓度>30%、机械通气差异有统计学意义(P<0.05)。多因素logistic回归分析显示胎龄、吸氧浓度>30%、机械通气是ELBWI和VLBWI发生BPD的独立危险因素(P<0.05)。BPD组患儿住院时间长,住院期间输血、重度贫血、水肿、PNAC、EUGR、甲功异常发生率高(P<0.05)。结论ELBWI和VLBWI发生BPD与多种因素有关;预防早产、产前予足量激素保胎、降低吸氧浓度、减少机械通气、预防重度窒息、积极的营养管理是预防BPD发生的重要措施。

Objective To explore the risk factors and complications of extremely low birth weight infants(ELBWI)and very low birth weight infants(VLBWI)with broncho-pulmonary dysplasia disease(BPD).Methods Extremely low birth weight infants and very low birth weight infants in the neonatal pediatrics department of Affiliated Hospital of Jining Medical University were enrolled in this study from January 1,2019 to January 1,2020,and were divided into BPD group and control group(non-BPD group).The differences between the two groups and risk factors of BPD were analyzed with independent-samples T test or chi-square test and multivariate logistic regression analysis.Results A total of 140 cases were included in the study.There were 10 cases of extremely low birth weight infant,130 cases of very low birth weight infants,71 cases in the non-BPD group,and 69 cases in the BPD group.The gestational age,birth weight,prenatal sufficient hormone,Apgar score≤3 points,oxygen concentration>30%and mechanical ventilation were associated with the occurrence of BPD in extremely and very low birth weight infants(P<0.05);Multivariate logistic regression analysis showed that the gestational age,oxygen concentration>30%and mechanical ventilation is the independent risk factor of the occurance of BPD in extremely and very low birth weight infants(P<0.05).The incidence of hospital stay,blood transfusion,severe anemia,edema,PNAC,EUGR,and thyroid function abnormalities in BPD group was higher than that in non-BPD group(P<0.05).Conclusion The prevalence of BPD in ELBWI and VLBWI can be influenced by many factors.Prevention of preterm delivery,adequate glucocorticoids to promote lung maturation,reduction of inhaled oxygen concentration,reduction of mechanical ventilation,prevention of severe asphyxia and active nutrition management may decrease the occurrence of BPD.