早产儿支气管肺发育不良的影响因素分析

Analysis of the influencing factor of bronchopulmonary dysplasia in premature infants

目的:分析早产儿支气管肺发育不良(BPD)的危险因素,为临床防治早产儿BPD提供参考。方法:选取胎龄<37周且存活≥28 d的早产儿共986例,将其分为非BPD组和BPD组。回顾性分析2组患儿的性别、胎龄、分娩方式、出生体质量、母亲年龄、动脉导管闭合情况、呼吸机相关肺炎、肺出血、贫血、早产儿高胆红素血症、用氧时间、住院时间等资料。结果:986例早产儿中,诊断为BPD共138例,发生率为14.00%。非BPD组和BPD组患儿母亲年龄差异无统计学意义(P>0.05),而2组胎龄、出生体质量、用氧时间和住院时间差异均有统计学意义(P<0.01)。不同特征早产儿间的BPD发生率比较显示,不同性别、有无呼吸窘迫综合征早产儿的BPD发生率差异均无统计学意义(P>0.05);而不同胎龄和是否母亲妊娠期高血压、羊水污染、使用肺表面活性物质、肺出血、动脉导管未闭合、早产儿贫血及机械通气早产儿间的BPD发生率差异均有统计学意义(P<0.05~P<0.01)。多因素logistic回归分析显示,低胎龄、使用肺表面活性物质、羊水污染、动脉导管未闭合和机械通气均为早产儿BPD的独立影响因素(P<0.05)。结论:影响BPD发生率的因素较多,在胎龄<30周的早产儿中,避免羊水污染、使用肺表面活性物质及合理减少机械通气时间有助于减少早产儿BPD的发生。

ObjectiveTo analyze the influencing factor of bronchopulmonary dysplasia（BPD） in premature infants for providing areference in the clinical prevention and treatment of premature infants with BPD. Methods：Nine hundred and eighty-six prematureinfants（gestational age 〈 37 weeks and survival ≥28 d） were divided into the non-BPD group and BPD group. The data of gender,gestational age,mode of delivery,birth weight,maternal age,arterial occlusion,ventilator-associated pneumonia,pulmonary hemorrhage,anemia,premature infants with hyperbilirubinemia,use oxygen time and hospitalization time in two groups were retrospectively analyzed.Results：Among the 986 premature infants,138 cases with BPD were diagnosed,the incidence rate of which was 14%. The difference ofthe maternal age between two groups was not statistically significant（P 〉 0. 05）,and the differences of gestational age,birth weight,useoxygen time and hospitalization time between two groups were statistically significant（P 〈 0. 01）. The differences of the incidence rateof BPD in different genders of premature infants, and premature infants with or without respiratory distress syndrome were notstatistically significant（P 〉 0. 05）. The differences of the incidence rate of BPD in different gestational age,gestational hypertension,amniotic fluid pollution,pulmonary surfactant use,pulmonary hemorrhage,ADA,anemia and mechanical ventilation in premature infantswere statistically significant（P 〈 0. 05 to P 〈 0. 01）. The multiple logistic regression analysis showed that the low gestational age,usepulmonary surfactant,amniotic fluid pollution,PDA and mechanical ventilation were the independent influencing factor in the incidenceof BPD of premature infants（P 〈 0. 05）. Conclusions：The influencing factor of the incidence of BPD of premature infants is more.Among the premature infants with gestational age less than 30 weeks, avoiding amniotic fluid pollution and reasonable reducingmechanical ventilation time can help to reduce the BPD of premature infants.