早产儿慢性肺疾病的高危因素和预后分析

Analysis on the risk factors and the prognosis of chronic lung disease in premature infants

目的探讨早产儿慢性肺疾病（CLD）的患病危险因素及预后分析。方法统计我院新生儿重症监护病房（NICU）12年间收治的CLD患儿，总结患儿的出生体重、性别、有否围生期窒息、孕周、原发疾病、机械通气时间、用氧浓度、吸气峰压、呼吸暂停、并发症及预后。结果（1）12年间NICU收治的922例早产儿中，发生CLD52例，发生率为5．64％。出生体重1501～2500g早产儿、极低出生体重儿（1001～1500g）和超低出生体重儿（≤1000g）CLD发生率分别为2．37％、12．09％和23．52％．有非常显著性差异（x。=42．92，P〈0．01）。（2）出生体重≤1500g．有围生期窒息，胎龄≤32周，呼吸窘迫综合征机械通气，吸氧浓度≥60％，动脉导管未闭，呼吸暂停，气胸，感染是CLD的高危因素。而性别，吸气峰压与CLD无明显关系。结论早产儿CLD是由多种因素所致，需综合治疗。

Objective To explore the risk factors and prognosis of chronic lung disease（CLD） in preterm infants, Methods Preterm infants with CLD hospitalized in our NICU from July, 1993 to June, 2005 were analyzed retrospectively. Data for review included birth weight, sex, neonatal asphyxia, gestational age, primary disease, ventilation support times, FiO2, PIP, apnea, comorbidity and prognosis. Results （ 1 ）The total number of the preterm infants was 922 during 12 years. There were 52 CLD and the morbidity rate was 5.64% .The CLD rate of premature infants with birth weight 1 501-2 500 g, 1 001-1 500 g, ≤1 000 g were 2.37 %, 12.09 % and 23.52 % respectively. There was significant difference in the 3 groups, （2）The incidence of CLD is comparatively high in premature infants with the following characterlstics：blrth weight less than 1 500 g, neonatal asphyxia, gestational age less than 32 weeks, RDS, ventilation support, FiO2≥60 %, PDA, apnea, pneumothorax and lung infection. Conclusion Multiple factors contribute to CLD, thus comprehensive therapy is necessary.