支气管肺发育不良极低出生体重早产儿生后4天内液体摄入量和中心静脉压特点分析

Fluid intake and central venous pressure within 4 days after birth in very low birth weight premature infants complicated with bronchopulmonary dysplasia

目的探讨支气管肺发育不良(bronchopulmonary dysplasia,BPD)极低出生体重(very low birth weight,VLBW)早产儿生后4 d内液体摄入量及中心静脉压(central venous pressure,CVP)的特点。方法选择2015年2月至2019年3月广州中医药大学深圳医院(福田)和中山大学附属东华医院新生儿病房做过CVP监测的VLBW早产儿进行回顾性研究,入选早产儿生后均每4~6 h进行CVP测定,并无严重并发症。按临床结局分为BPD组和非BPD组,比较两组患儿生后4 d内液体摄入量及CVP。结果共纳入45例VLBW早产儿,其中BPD组17例,非BPD组28例。BPD组生后4 d内的液体摄入量稍多于非BPD组,但差异无统计学意义(P>0.05);所有研究对象生后1~4 d液体摄入量与CVP无关(r=0.093,P=0.542)。BPD组生后1~4 d CVP分别为(3.97±0.68)、(4.49±0.75)、(4.55±0.66)、(4.02±1.05)cmH2O,非BPD组分别为(3.66±1.09)、(3.96±0.76)、(3.81±0.69)、(3.91±0.65)cmH2O,BPD组高于非BPD组,差异有统计学意义(P<0.05);BPD组生后2、3 d CVP有升高趋势(P<0.05)。结论VLBW早产儿并发BPD者出生早期存在CVP相对升高的现象,但这种现象与液体输入量可能无直接关系。

Objective To study the characteristics of fluid intake and central venous pressure(CVP)within 4 days after birth in very low birth weight(VLBW)premature infants complicated with bronchopulmonary dysplasia(BPD).Method From February 2015 to March 2019,VLBW preterm infants without serious complications were enrolled in two hospitals.Their CVP were measured every 4~6 hours after birth.They were assigned into BPD group and non-BPD group,and the fluid intake and CVP within 4 days after birth were compared between these two groups.Result A total of 45 VLBW preterm infants were included,including 17 in the BPD group and 28 in the non-BPD group.The fluid intake in the BPD group showed no significant difference with the non-BPD group within 4 days after birth(P>0.05).No significant correlation existed between the mean liquid intake and the mean CVP in 1~4 days after birth(r=0.093,P=0.542).From day1 to day4,the CVPs of the BPD group were(3.97±0.68),(4.49±0.75),(4.55±0.66),(4.02±1.05)cmH2O,and the non-BPD group were(3.66±1.09),(3.96±0.76),(3.81±0.69),(3.91±0.65)cmH2O.The differences between the BPD group and the non-BPD group were statistically significant(P<0.05).The CVP of the BPD group was increasing from day 2 to day 3(P<0.05).Conclusion VLBW premature infants complicated with BPD may have higher CVP at the early stage of life,which may not be related with the fluid intake.