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目的分析早产儿支气管肺发育不良症(BPD)的发生率和高危因素,探讨BPD的诊治措施。方法回顾分析苏州大学儿童医院2002-01—2006-10在NICU诊治的孕周<32周的极低出生体重儿145例的临床资料。71例均有机械通气史,其中13例诊断为BPD(BPD组),而58例为非BPD组,对两组临床资料进行对照研究。结果孕周<32周的极低出生体重儿BPD的总发生率是10.34%,而有气管插管呼吸机辅助呼吸史的极低出生体重儿BPD的发生率高达18.31%。BPD组患儿胎龄和产重均较非BPD组低,胎膜早破史及合并PDA者BPD组均较对照组明显增高,有统计学意义(P<0.05);入院时间、肺表面活性物质(PS)的应用、有无窒息史均无明显差异,P>0.05;两组患儿在高浓度吸氧、PIP、PEEP及MAP几个呼吸机参数上差异无显著性(P>0.05),而上机时间和吸氧时间在两组间差异有显著性(P<0.05)。结论避免早产低体重、长时间吸氧机械通气、控制肺部反复感染是防止BPD的关键,积极早期综合治疗BPD疗效肯定,小剂量激素治疗有较好效果。
Objective To analyze the incidence and risk factors of bronchopulmonary dysplasia (BPD) in premature infants and to explore the diagnosis and treatment of BPD. Methods The clinical data of 145 cases of very low birth weight infants who were <32 weeks gestational age undergoing diagnosis and treatment in NICU from January 2002 to June 2006 at Children’s Hospital of Soochow University were retrospectively analyzed. All 71 patients had a history of mechanical ventilation, of which 13 cases were diagnosed as BPD (BPD group) and 58 cases were non-BPD group. The clinical data of the two groups were compared. Results The overall incidence of BPD in very low birth weight infants <32 weeks gestational age was 10.34%. The incidence of BPD was very high in 18.31% of those with very low birth weight infants with respiratory history of tracheal intubation. BPD group gestational age and birth weight were lower than the non-BPD group, premature rupture of membranes and BPD patients with PDA were significantly higher than the control group, with statistical significance (P <0.05); admission time, pulmonary surfactant There was no significant difference in the application of substance (PS) and the presence or absence of asphyxia (P> 0.05). There was no significant difference between the two groups in parameters of ventilator with high concentration of oxygen, PIP, PEEP and MAP , While the machine time and oxygen time in the two groups were significantly different (P <0.05). Conclusions Avoiding premature birth, low birth weight, prolonged oxygen inhalation ventilation and repeated lung infection control is the key to preventing BPD. Positive active early comprehensive treatment of BPD is effective and small dose of hormone therapy is effective.