急性呼吸窘迫综合征早产儿发生支气管肺发育不良的危险因素分析

Analysis of risk factors for the occurrence of bronchopulmonary dysplasia in premature infants with acute respiratory distress syndrome

目的探讨分析急性呼吸窘迫综合征(ARDS)早产儿发生支气管肺发育不良的危险因素。方法选取2018年10月至2022年10月丹阳市妇幼保健院新生儿重症监护室(NICU)收治的128例合并患有新生儿ARDS,胎龄<32周,出生时体重<1500 g的早产儿作为本研究对象,根据诊断是否出现支气管肺发育不良(BPD)分为BPD组(48例)与非BPD组(80例),收集所有患儿的出生及临床治疗情况以及患儿母亲的孕期情况进行分析,并对该病的防治策略进行总结。结果本研究共纳入患有ARDS早产儿128例,其中确诊为BPD的有48例,其发病率为37.50%(48/128);对两组早产儿临床相关因素进行分析比较得出,胎龄、出生时体重、机械辅助通气以及产儿感染发生率比较,差异有统计学意义(P<0.05);在对两组早产儿母亲进行相关因素的比较中得出,两组早产儿母亲的产前感染发生率比较,差异有统计学意义(P<0.05);根据多因素logistic回归分析得出,胎龄<28周、出生时体重<1000 g、机械辅助通气、产儿感染、新生儿母亲产前感染因素为BPD发生的危险因素(P<0.05)。结论做好围生期保健工作,避免低体重早产儿,减少应用机械通气的时间,有效防止和降低新生儿肺部感染以及新生儿母亲产前感染是预防ARDS早产儿合并出现BPD的重要举措。

Objective To explore and analyze the risk factors for the occurrence of bronchopulmonary dysplasia(BPD)in premature infants with acute respiratory distress syndrome.Methods A total of 128 premature infants with acute respiratory distress syndrome,gestational age less than 32 weeks and birth weight less than 1500 g,who were admitted to the neonatal intensive care unit(NICU)of Danyang Maternal and Child Health Care Hospital from October 2018 to October 2022,were selected as the subjects of this study.Through diagnosis,the infants were divided into the BPD group(48 cases)and the non-BPD group(80 cases)according to their presence or absence of BPD.The birth and clinical treatment of all children and pregnancy situation of the children’s mothers were collected and analyzed,and the prevention and treatment strategies of the disease were summarized.Results A total of 128 premature infants with ARDS were included in this study,of which 48 were diagnosed with BPD,with a prevalence rate of 37.50%(48/128).Analysis of the clinical factors associated with premature infants revealed that there were significant differences between the two groups in gestational age,birth weight,mechanically assisted ventilation and the incidence of infection in the infants born(P<0.05).Meanwhile,a significant difference(P<0.05)was found in the incidence of antenatal infections of newborn mothers in the two groups when comparing factors related to prematurity.According to multivariate logistic regression analysis,gestational age of less than 28 weeks,birth weight<1000 g,mechanically assisted ventilation,perinatal infection,and prenatal infection of newborn mothers were all risk factors for the development of BPD(P<0.05).Conclusion Improving perinatal care,avoiding low birth weight in premature infants,reducing the time to apply mechanical ventilation,and effectively preventing and reducing neonatal lung infections as well as antenatal infections of newborn mothers are vital initiatives to prevent the comorbid development of BPD in premature infants with ARDS.