超低出生体质量儿支气管肺发育不良的危险因素分析

目的 探讨超低出生体质量儿(ELBWI)支气管肺发育不良(BPD)的危险因素.方法 对2010年1月至2015年12月入住山东大学附属省立医院及四川省人民医院新生儿重症监护病房(NICU),出生后24 h内入院且存活至生后28 d以上的151例ELBWI的临床资料进行调查分析.BPD组纳入任何氧依赖[吸入氧浓度(FiO2)＞21％]超过28 d的新生儿,反之为非BPD组.比较两组间母亲孕期因素、新生儿因素及疾病治疗因素.结果 (1)151例ELBWI,发生BPD 57例,发生率为37.7％.(2)单因素分析结果显示,母亲是否患有绒毛膜羊膜炎、胎膜早破时间、出生体质量、胎龄、败血症、动脉导管未闭(PDA)、新生儿呼吸窘迫综合征(NRDS)、机械通气(MV)、MV时间、静脉营养时间、输血次数与ELBWI发生BPD相关,应用咖啡因是保护因素.(3)多元Logistic回归显示MV(OR=6.975,95％CI:1.464～33.219),母亲患有绒毛膜羊膜炎(OR=3.890,95％CI:1.656～9.140)是ELBWI发生BPD的独立危险因素.结论 尽可能减少宫内感染及早产,产后合理进行呼吸支持,可有效降低ELBWI的BPD发生率.

Analysis of risk factors for extremely low birth weight infants with bronchopulmonary dysplasia

Objective To explore the risk factors of extremely low birth weight infants(ELBWI) with bronchopulmonary dysplasia(BPD).Methods The clinical data in 151 ELBWI in NICU of the Provincial Hospital Affiliated to Shandong University and Sichuan Provincial People's Hospital from 2010 to 2015,admitted at 24 after birth and survived until to 28 h after birth,were performed the survey analysis.The newborns of oxygen dependency(FiO2 ＞ 21％) more than 28 d were included into the BPD group,on the contrary,the newborns were included into the non-BPD group.The maternal pregnant factors,neonatal factors and disease treatment factors were compared between the two groups.Results (1) Among 151 ELBWI,57 cases developed BPD with incidence rate of 37.7 ％.(2) The univariate analysis results showed that maternal chorioamnionitis,premature rupture of membrane more than 18 h,birth weight,gestational age,sepsis,patent ductus arteriosus (PDA),neonatal respiratory distress syndrome (NRDS),mechanical ventilation(MV),MV time,parenteral nutrition time,frequency of blood transfusion were associated with the BPD occurrence in ELBWI.Caffeine use was a protective factor.(3)The multivariate Logistic regression analysis displayed that MV (OR=6.975,95％CI:1.464-33.219) and maternal chorioamnionitis(OR=3.890,95％CI:1.656-9.140) were the independent factors of BPD occurrence in ELBWI.Conclusion Reducing intrauterine infection and preterm birth as far as possible and reasonable respiratory support after birth can effectively reduce the incidence rate of BPD in ELBWI.