动态分析生长发育迟缓与支气管肺发育不良严重程度的关系

Dynamic analysis of growth retardation and the severity of bronchopulmonary dysplasia

目的动态监测支气管肺发育不良(BPD)患儿出生后至出院前体重、身长、头围的增长情况,分析不同时期生长迟缓程度与BPD严重程度的相关性,以期为临床诊治BPD提供参考依据。方法收集2016年1月1日—2019年12月31日生后24h内于本院NICU住院,最终诊断为BPD的167例患儿住院期间的体重、身长、头围数据,胎龄及氧疗等情况。结果符合入组标准的BPD患儿共159例,轻度79例、中度52例、重度28例。出生体重(χ^(2)=13.958,P=0.001)、男婴(χ^(2)=7.451,P=0.024)、产前使用激素(χ^(2)=11.287,P=0.004)、机械通气(χ^(2)=14.346,P=0.001)、氧疗总时长(Z=14.750,P=0.001)与BPD严重程度比较,差异均有统计学意义。体重、身长、头围方面:出生时,有无生长发育迟缓组间比较,差异有统计学意义(H体重=-5.429,H身长=-9.632,H头围=-9.632,P<0.001);生后28 d(H体重=-6.726,H身长=-6.254,H头围=-6.254,P<0.001)与纠正胎龄36周(H体重=-7.091,H身长=-7.178,H头围=-7.178,P<0.001)组间比较生长迟缓程度,差异均有统计学意义。结论体重、身长、头围的生长迟缓可能与BPD严重程度有一定的关系,临床中需注意合理营养,促进均匀生长。

Objective To dynamically monitor the increase of body weight, body length and head circumference of children from birth to discharge, and to analyze the correlation between growth retardation and severity of bronchopulmonary dysplasia(BPD)in different periods, so as to provide reference for clinical diagnosis and treatment of BPD. Method The data of body weight, body length, head circumference, gestational age and oxygen therapy were collected from 167 infants admitted to the NICU of Children′s Hospital of Suchou University from January 1 st, 2016 to December 31 st, 2019 who were diagnosed with BPD within 24 hours after birth. Results A total of 159 children with BPD met the inclusion criteria, including 79 cases with mild BPD, 52 cases with moderate BPD, and 28 cases with severe BPD. There were significant differences on birth weight, male infants, antenatal corticosteroids, mechanical ventilation, oxygen therapy duration among children in different severity groups(χ^(2)=13.958, 7.451, 11.287, 14.346, Z=14.750,P<0.05 or <0.01). There were significant difference on body weight, length and head circumference between children with or without growth retardation(Hweight=-5.429, Hlength=-9.632, Hhead circumference=-9.632, all P<0.001). And the differences were significant between the two groups on the 28 th days after birth(Hweight=-6.726, Hlength=-6.254, Hhead circumference=-6.254, all P<0.001) and at corrected gestational age of 36 weeks(Hweight=-7.091,Hlength=-7.178, Hhead circumference=-7.178, all P<0.001). Conclusions Growth retardation of body weight and length may be related to the severity of BPD. In clinical practice, preterm infants should be given reasonable nutrition in order to promote uniform growth.