新生儿支气管肺发育不良47例临床分析

Clinical Analysis of 47 Cases of Neonatal Bronchopulmonary Dysplasia

目的分析引发新生儿出现支气管肺发育不良的危险因素、临床特点、诊疗方法及预后情况。方法选择某院自2014年1月-2017年10月收治的47例支气管肺发育不良新生儿作为研究组,选择同期住院的47例未发生支气管肺发育不良的健康新生儿作为设为对照组,比较两组新生儿的胎龄、体重、肺部感染情况、给氧时间以及机械通气时间,另外,观察和记录研究组患儿的临床特点、治疗、预后及并发症发生情况。结果研究组新生儿的胎龄、体重明显低于对照组,研究组新生儿出生时的肺部感染发生率明显高于对照组,研究组新生儿的给氧时间和机械通气时间明显长于对照组,两组对比差异有统计学意义,P<0.05。经综合治疗,研究组中共有45例患儿存活,2例患儿死亡,且死亡患儿的病程明显长于存活患者。另外,存活患儿并发症的发生率为68.9%,并发症类型为消化道出血、肺出血、肺不张和呼吸机相关性肺炎等。结论引发新生儿出现支气管肺发育不良的危险因素有早产、低体重、出生时肺部感染以及吸氧和使用呼吸机时间过长等。尽早确诊和采取综合性治疗能有效提高患儿的存活率,但并不能有效控制和降低其并发症的发生率,为此,临床可根据疾病的致病因素,做好早期的预防和控制措施。

Objective To analyze the risk factors,clinical features,diagnosis and treatment of bronchopulmonary dysplasia and their prognosis in neonates.Methods 47 children with bronchopulmonary dysplasia who were admitted to a hospital from January 2014 to October 2017 were selected as the study group（as the study group）,and47 healthy infants without bronchopulmonary dysplasia who were hospitalized during the same period were selected.As a reference group（as a control group）,the gestational age,body weight,pulmonary infection,oxygen supply time,and mechanical ventilation time were compared between the two groups of newborns.In addition,the clinical characteristics,treatment,and prognosis of the study group were observed and recorded.And the occurrence of complications.Results The gestational age and body weight of newborns in study group were significantly lower than those in control group.The incidence of pulmonary infection at birth in study group was significantly higher than that in control group.The oxygenation time and mechanical ventilation time of neonates in study group were significantly longer than those in control group,the difference between the two groups was significant（P〈0.05）.After the comprehensive treatment,a total of 45 children in the study group survived,two died,and the duration of death was significantly longer than that in the survivors.In addition,the incidence of complications of survival in children was 68.9%,the type of complications were gastrointestinal bleeding,pulmonary hemorrhage,atelectasis and ventilator-associated pneumonia.Conclusions Risk factors for bronchopulmonary dysplasia in newborns are premature delivery,low birth weight,pulmonary infection at birth,and oxygen inhalation and ventilator use.Early diagnosis and comprehensive treatment can effectively improve the survival rate of children,but it can not effectively control and reduce the incidence of complications,therefore,the clinical disease according to the risk factors,good early prevention and control measures.