极低出生体重儿支气管肺发育不良的高危因素及防治

Risk factors and prevention of bronchopulmonary dysplasia in very low birth weight infant

目的:探讨极低出生体重儿(VLBWI)支气管肺发育不良(BPD)的危险因素,提出有效的防治措施。方法:选取2013年1月至2017年12月在本院住院的130例有BPD的VLBWI作为BPD组,非BPD组选择同期住院的另外120例VLBWI。比较两组VLBWI的性别,胎龄,出生体重,是否应用机械通气,是否使用肺泡表面活性物质、肾上腺皮质激素等药物,是否存在感染,是否输血,是否发生动脉导管未关闭、呼吸暂停及新生儿呼吸窘迫综合征(NRDS)等合并症,探讨VLBWI BPD的危险因素,并提出有效的防治策略。结果:Logistic回归分析提示,男性、胎龄小、低出生体重、机械通气、发生NRDS、并发呼吸暂停为VLBWI BPD的高危因素。结论:减少机械通气、预防早产和低出生体重、应用兴奋呼吸中枢药物、预防NRDS及呼吸暂停能减少VLBWI BPD的发生。

Objective:To investigate high risk factors of very low birth weight infants with bronchopulmonary dysplasia and put forward effective prevention strategies.Methods:Totally 130 very low birth weight infants with bronchopulmonary dysplasia and 120 very low birth weight infants without bronchopulmonary dysplasia in our hospital were recruited from January,2013 to December,2017.Gender,gestational age,birth weight,the use of mechanical ventilation,the use of medicine including pulmonary surfactant and adrenocortical hormone,infection,blood transfusion,patent ductus arteriosus,apnea,neonatal respiratory distress syndrome and others were collected to analyze high risk factors of bronchopulmonary dysplasia,and providing effective prevention strategies.Results:Logistic regression analysis showed that male,small gestational age,low birth weight,mechanical ventilation,apnea and neonatal respiratory distress syndrome were high risk factors of very low birth weight infants with bronchopulmonary dysplasia.Conclusion:Reducing the use of mechanical ventilation,preventing premature delivery and low birth weight,usage of respiratory stimulants,and preventing apnea and neonatal respiratory distress syndrome can reduce the incidence of very low birth weight infants with bronchopulmonary dysplasia.