早产儿支气管肺发育不良症临床分析

Clinical analysis of bronchopulmonary dysplasia in premature infants

目的了解早产儿支气管肺发育不良(BPD)的临床特点。方法 2007年1月至2009年12月本院新生儿重症监护病房收住920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 920例早产儿中24例发生BPD,胎龄<28周6例,28～30周13例,～32周3例,～35周2例;出生体重<1000g 6例,1000～1500g 13例,～2500g 5例;轻度BPD 13例,中度BPD 6例,重度BPD 5例;需要机械通气时间为(1.04±26.35)d,需吸氧时间为(47.22±22.49)d,住院时间为(65.29±23.46)d。BPD患儿中合并肺部感染37.5%,脑积水16.7%,早产儿视网膜病16.7%,动脉导管未闭20.8%。所有病例经综合治疗治愈14例,放弃治疗后死亡5例,好转5例,其中3例出院后6个月内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,故积极预防早产,尽量避免机械通气以及减少机械通气、吸氧时间,积极预防和治疗肺部感染及关闭动脉导管可能会减少BPD的发生。

Objective：To summarize and discuss character of bronchopulmonary hypoplasia of premature infants.Methods：To rewiew cases of 920 premature infants.To summarize and analyze characteristics of gestation age,birthweight,primary disease,X-ray and treatment process.Results：In 920 cases,there were 24 cases of bronchopulmonary hypoplasia.Disposition of gestation age： less than 28w 6 cases,between 28w and 30w 13 cases.between 30w and 32w 3 cases,between 32w and 35w 2 case.Disposition of birthweight： less than 1000g 6 cases,between 1000g and 1500g 13 cases,between 1500g and 2500g 5 cases,more than 2500g 2 cases.Grade of pathogenetic condition： trivial bronchopulmonary hypoplasia 13 cases,midrange bronchopulmonary hypoplasia 6 cases,severe bronchopulmonary hypoplasia 5 cases.Average time of mechanical ventilation（15.04±26.35）d,average time of inhaling dephlogisticated air（47.22±22.49）d;time of average stay（65.29±23.46）d.The proportions of the complication with pulmonary infection,hydrocephalus,retinopathy of prematurity（ROP）,patent ductus arteriosus（PDA） were respectively 37.5%,16.7%,16.7%,20.8%.Death 5 cases after giving up treatment,healing 14 case,improvement 5 cases;3 cases were in hospital again because of pulmonary infection during six months.Conclusion： BPD were associated with premature infant lung developmental immaturity,the time for ventilation,oxygen administration,infecton.Measures should be taken to prevent premature,lower the time of ventilation and oxygen administration possibly,control infecton positively,prevent PDA,which should help decrease BPD incidence and improve the quality of life of preterm infants.