极低出生体重儿支气管肺发育不良的高危因素及预防对策

The Risk Factors for Bronchopulmonary Dysplasia in Very Low Birth Weight Infants(VLBWI)

目的:分析极低出生体重儿支气管肺发育不良症(BPD)的高危因素,探讨BPD的预防方法。方法:回顾分析深圳南山医院2006年1月-2009年9月在NICU诊治的极低出生体重儿75例的临床资料。其中13例诊断为BPD(BPD组),而62例为非BPD组,对两组临床资料进行对照研究。结果:极低出生体重儿BPD的总发生率是17.33%,而有机械通气史的极低出生体重儿BPD的发生率高达33.33%,经鼻气道正压通气的极低出生体重儿BPD的发生率较低,为10.34%。BPD组患儿胎龄和产重均较非BPD组低。产前发生绒毛膜羊膜炎、接受机械通气、合并肺部感染、需多次输血的患儿,BPD组较非BPD组明显增高(P<0.05)。生后使用肺表活性物质,限制早期液体摄入量,控制感染,积极纠正贫血,在两组间差异有显著性(P<0.05)。结论:避免早产低体重、肺表面活性物质(PS)联合经鼻气道正压通气治疗肺透明膜病,限制生后前10d的液体摄入、控制肺部反复感染、积极纠正贫血是预防BPD的关键,积极早期综合治疗BPD疗效肯定。

Objective： To study the incidence, risk factors, prophylaxis and treatment for hronchopulmonary dysplasia （BPD）in very low birth weight infants. Methods.. From January 2006 to September 2009,75 very low birth weight infants in NICU were enrolled in the study. 13 with BPD were compared to 62 ones without BPD in the clinical materials. Results：The total incidence of BPD in the very low birth weight infants was 17. 33%,and 33. 33% in those infants with mechanical ventilation, 10. 34% in those infants with nasal continuous positive airway pressure（nCPAP）combined with pulmonary surfaetant（PS）. The gestational age and birth weight of BPD group were lower than those without BPD, and the rates of amniocentesis and complicated PDA in BPD group were higher than those of the control（P〈0. 05）. The use of PS, reducing fluid intake during the first ten days of life, controlling pulmonary infection, managing anemia have been found different between the two groups （P〈0. 05 ）. Conclusion： Preventing premature labor, nCPAP combining with PS,reducing fluid intake during the first ten days of life, managing anemia effective in preventing BPD.