支气管肺发育不良17例及文献复习

Analysis of 17 cases of bronchopulmonary hypoplasia and literature review

目的了解早产儿支气管肺发育不良(BPD)的临床特点。方法2003-09—2006-12在温州医学院附属育英儿童医院收住1325例早产儿,对其胎龄、出生体重、原发疾病、肺部X线表现、治疗经过等临床资料进行分析。结果1325例早产儿中17例发生BPD,胎龄<28周4例,28～30周4例,～32周4例,34周1例,4例不详;出生体重<1000g4例,1000～1500g4例,～2500g4例,>2500g2例,2例不详;轻度BPD10例,中度BPD4例,重度BPD3例;需要机械通气时间为(29.7±14.2)d,需吸氧时间为(35.2±15.4)d,吸入氧体积分数>0.60时间为(97.3±11.4)h,住院时间为(45.6±49.9)d。所有病例均合并肺部感染,经综合治疗自动出院4例,死亡2例,治愈1例,好转10例,好转患儿均因肺部感染再次住院。结论早产儿肺发育不成熟、长时间吸氧及机械通气、肺部感染是BPD发生的主要因素,应加强对BPD的早期诊断及合理的综合治疗措施。

Objective To summarize and discuss character of bronchopulmonary hypoplasia of premature infants. Methods To rewiew cases of 1325 premature infants. To summarize and analyze characteristics of gestation age, birth weight, primary disease,X-ray and treatment process. Results In 1325 cases,there were 17 cases of bronchopulmonary hypopla- sia. Disposition of gestation age：less than 28w 4 cases,between 28w and 30w 4 cases, between 30w and 32w 4 cases,34w t case,4 cases not in detail. Disposition of birth weight：less than 1000g 4 cases,between 1000g and 1500g 4 cases,between 1500g and 2500g 4 cases, more than 2500g 2 cases, 2 cases not in detail. Grade of pathogenetic condition： trivial bronchopulmonary hypoplasia 10 cases, midrange bronchopulmonary hypoplasia 4 cases, severe bronchopulmonary hypoplasia 3 cases. Average time of mechanical ventilation 129. 7 ± 14. 2 ） d, average time of inhaling dephlogisticated air （35.2 ± 15.4 ） d; time of concentration of dephlogisticated air inspired more than 60% （97. 3± 11.4 ） h, average stay 145.6 ± 49. 9 ） d. All cases complicated with pulmonary infection. Automation discharge 4 cases, death 2 cases, healing 1 case, improvement 10 cases ;improved cases were all in hospital again because of pulmonary infection. Conclusion Premature infant lung developmental immaturity,long time inhaling dephlogisticated air and pulmonary infection are the chief etiological factors of bronchopulmonary hypoplasia. Early dianosis and reasonable combined therapy are requisite.