极低/超低出生体重儿支气管肺发育不良的危险因素分析

Risk factors of bronchopulmonary dysplasia in very low/extremely low birth weight infants

目的分析极低/超低出生体重儿支气管肺发育不良(BPD)的危险因素。方法对我院2014年6月至2018年12月新生儿重症监护室收治的胎龄<32周且存活>14 d的278例极低/超低出生体重儿进行回顾性上分析,了解BPD的危险因素。结果共纳入新生儿278例(BPD组106例,非BPD组172例),BPD组贫血、输血、生后1 min Apgar评分≤7分、新生儿呼吸窘迫综合征(NRDS)、使用肺表面活性物质(PS)、动脉导管未闭(PDA)、新生儿肺炎、败血症、机械通气≥7 d、持续气道正压通气(CPAP)≥30 d的比例均高于非BPD组。男婴、胎龄、合并NRDS、CPAP≥30 d、机械通气≥7d是发生BPD的危险因素。结论极低/超低出生体重儿BPD的发生与男婴、胎龄、NRDS、机械通气及CAPA有关,是BPD发生的高危因素。预防早产、减少有创通气时间、合理治疗NRDS、积极控制感染,可能有助于降低BPD的发生率。

Objective To analyze risk factors of the very low/extremely low birth weight infants with bronchopulmonary dysplasia(BPD). Methods From June 2014 to December 2018, a total of 278 cases of the very low/extremely low birth weight infants with gestational age<32 weeks who survived>14 d were admitted to NICU of our hospital and the risk factors of BPD were analyzed. Results A total of 278 preterm infants were included(106 BPD cases, 172 non-BPD cases).The incidences of complications in BPD group including anemia of prematurity, red blood cell transfusion, Apgar score at 1min≤7, neonatal respiratory distress syndrome(NRDS), using pulmonary surfactant(PS), patent ductus arteriosus(PDA),neonatal pneumonia, sepsis, mechanical ventilation≥7 d, continuous positive airway pressure(CPAP)≥30 d, were higher than that in non-BPD group. The risk factors of BPD were male, gestational age, NRDS, CPAP≥30 d, mechanical ventilation≥7 d.Conclusion The incidence of BPD in very low/extremely low birth weight infants was associated with male, gestational age,NRDS, CPAP≥30 d, mechanical ventilation≥7 d, which were the high risk factors for BPD. Prevention of preterm delivery,reducing invasive ventilation, rational treatment of NRDS, and preventing infection may decrease the incidence and severity of BPD.