支气管肺发育不良早产儿的临床特征及危险因素分析

Clinical characteristics and risk factors of premature infants with bronchopulmonary dysplasia

摘要:

目的 分析支气管肺发育不良（BPD）早产儿的临床特征及潜在危险因素，为早产儿BPD的临床治疗和预防提供理论依据。方法 回顾性分析2017年1月—2018年3月新疆生产建设兵团医院新生儿科住院，胎龄≤34周，出生即转入新生儿重症监护病房（NICU）的168例早产儿临床资料。其中BPD 52例（观察组），未患BPD 116例（对照组）。比较分析患儿BPD的发生率，BPD的发生与胎龄、出生体重及宫内发育情况的关系，对各种BPD发病因素，如肺部反复感染、机械通气时间、吸氧时间、产前感染、颅内出血等危险因素进行单因素及多因素分析。结果 胎龄≤28周、>28～30周、>30～32周、>32～34周早产儿的BPD发生率分别为55.88%、39.13%、19.51%和14.89%，体重≤1?000?g、>1?000～1?500?g、>1?500～2?000?g、>2?000?g早产儿BPD的发生率分别为66.67%、38.46%、20.41%和14.00%，差异有统计意义（P?<0.05）；BPD的发生与患儿产前感染、出生后机械通气、吸氧时间和肺部反复感染均有关（P?<0.05）；出生胎龄、出生体重、宫内发育情况、机械通气时间、吸氧时间、肺部反复感染情况及产前感染情况是BPD的独立危险因素（P?<0.05），与颅内出血无关（P?>0.05）。观察组机械通气时间、吸氧时间与对照组比较，差异有统计意义（P?<0.05），观察组高于对照组。结论 确保胎儿正常发育，减少患儿机械通气时间、吸氧时间，避免患儿肺部感染是减少BPD发生的重要措施。

Abstract:

Objective To investigate the clinical characteristics and risk factors of premature infants with bronchopulmonary dysplasia (BPD), so as to provide a theoretical basis for the clinical treatment and prevention of premature infants with BPD. Methods The data of the 168 cases of hospitalized premature infants with gestational ages under 34 weeks were retrospectively analyzed, and infants were divided into two groups according to the presence or absence of BPD, named observation group (n?=?52) and control group (n?=?116). The incidence of BPD, and its relationship with gestational age, birth weight and intrauterine development, as well as the risk factors including repeated pulmonary infection, mechanical ventilation time, oxygen inhalation time, prenatal infection, and intracranial hemorrhage were analyzed, including single factor and multiple factor analysis. Results The incidence rates of preterm infants with gestational age ≤ 28 w, to 30 w, to 32 w, and to 34 w were 55.88%, 39.13%, 19.51% and 14.89%, respectively. The incidence rates of BPD in premature infants was ≥ 1000?g, to 1?500?g, to 2?000?g and >?2?000?g were 66.67%, 38.46%, 20.41% and 14.00%, respectively, and the difference was statistically significant (P??0.05). The mechanical ventilation time and oxygen inhalation time of the observation group were significantly higher than those of the control group, and the difference was not significant (P?