雾化吸入布地奈德治疗超早早产儿支气管肺发育不良效果观察

目的 观察雾化吸入布地奈德对治疗超早早产儿(出生胎龄<28周)支气管肺发育不良(Bronchopulmona-ry Dysplasia,BPD)效果.方法 超早早产儿46例随机分为治疗组20例及对照组26例.治疗组从出生第28天采用布地奈德0.5 mg雾化吸入治疗,每日2次,共治疗10天;对照组在治疗过程中不使用布地奈...     

接受布地奈德雾化吸入治疗的支气管肺发育不良早产儿骨密度变化观察

目的 观察布地奈德雾化吸入治疗对支气管肺发育不良(Bronchopulmonarydysplasia,BPD)早产儿骨密度(Bone mineral density,BMD)的影响.方法 BPD早产儿222例,其中胎龄24+1～28周59例、胎龄28+1～32周者173例,胎龄24+1～28周患儿分为治疗A组32例与对...     

小剂量糖皮质激素预防早产儿支气管肺发育不良效果观察

目的：观察小剂量糖皮质激素预防早产儿支气管肺发育不良（ BPD）的临床效果。方法将90例出生后10 d仍需机械通气的早产儿随机分为观察组和对照组各45例,观察组静推地塞米松,对照组静推等量生理盐水,总疗程7～10 d。记录两组BPD发病率、呼吸机参数、吸氧时间及不良反应的发生情况。结果观察组BPD发病率为9％,对照组为67％,P＜0．01。观察组机械通气时间、吸氧时间和出生后30 d的体质量均低于对照组,P均＜0．01。两组吸入氧浓度（FiO2）、吸气峰压（PIP）、呼气末正压（PEEP）和平均动脉压（MAP）比较,P均＞0．05。观察组未发生严重激素使用并发症。结论小剂量糖皮质激素可有效预防早产儿BPD的发生,且安全性较高。     

支气管肺发育不良的早产儿脐带血Clara细胞分泌蛋白水平观察

目的 观察支气管肺发育不良(BPD)的早产儿脐带血Clara细胞分泌蛋白(CCSP)水平变化,探讨其对BPD的诊断价值.方法 选择107例早产儿,其中BPD患儿42例为BPD组,急性呼吸窘综合征(ARDS)患儿34例为ARDS组,单纯早产儿31例为对照组.收集三组脐带血,ELISA法检测脐带血CCSP,Pearson线...     

固尔苏治疗新生儿肺透明膜病

目的探讨不同剂量固尔苏治疗新生儿肺透明膜病临床疗效。方法研究组患儿在进行常规治疗基础上加用剂量为每千克200mg固尔苏联合治疗;对照组患儿在进行常规治疗基础上加用剂量为每千克100mg固尔苏联合治疗,观察并记录两组患儿治疗效果,进行统计学分析,得出结论。结果研究组与对照组患儿治疗前体内PaO2、PaCO2．pH对比结果无统计学意义,两组患儿体内pH经治疗后有所上升,但上升幅度较治疗前以及两组比较结果并不明显（P〉0．05）,两组患儿经治疗后体内PaO2显著上升,而PaCO2则显著下降,且研究组患儿变化效果更为明显（P〈0．05）,研究组患儿NCPAP持续时间、吸氧持续时间、再次使用固尔苏患儿所占比例均显著低于对照组;研究组患儿经治疗后,需再次进行固尔苏给药治疗患儿所占比例为28．57％,显著低于对照组66．67％,且P〈0．05,两组患儿对比结果具有统计学意义。结论使用大剂量固尔苏对新生儿肺透明膜病患儿进行治疗,较小剂量治疗患儿更能有效改善其体内血气情况,减少辅助通气及吸氧时间,快速控制病情,达到更为有效的治疗目的,值得临床推广应用。     

不同用药时间应用固尔苏治疗新生儿肺透明膜病疗效观察

新生儿肺透明膜病(HMD)是围产期常见的危重急症,也是围产期致死的主要原因之一。临床上关于肺表面活性物质治疗新生儿HMD最佳应用时间的研究不多。我院2002年1月至2003年12月应用肺表面活性物质制剂固尔苏治疗早产儿HMD24例,按用药时间分3组进行观察。现报告如下。     

巨细胞病毒感染与早产儿支气管肺发育不良的相关性探讨

目的 探讨临床巨细胞病毒（CMV）感染与早产儿支气管肺发育不良（BPD）的关系.方法 选取我院收治的42例支气管肺发育不良的早产儿作为观察组,另选取在我院生产的42例非支气管肺发育不良的早产儿作为对照组,通过酶联免疫吸附测定实验（ELISA）检查两组早产儿血清中的CMV-IgM及CMV-IgG抗体情况,比较两组早产儿发生巨细胞病毒感染情况.结果 检测结果显示观察组早产儿巨细胞感染率显著高于对照组,（P〈0.01）;而临床症状感染率观察组较对照组明显升高（P〈0.05）,有统计学意义.结论 CMV感染,尤其是症状性感染是引起早产儿BPD的重要因素之一.     

细胞因子在早产儿支气管肺发育不良中的表达与临床价值

目的 探讨血清细胞因子水平与早产儿支气管肺发育不良的关系(bronchopulmonary dysplasi-a).方法 检测我院新生儿科2019年3月——2020年9月入院的137例胎龄≤32周的早产儿生后28天内不同时间点的血清细胞因子水平,根据纳入及排除标准,最终确定83例为研究对象,按BPD的诊断标准分为BPD...     

固尔苏预防新生儿呼吸窘迫综合征的疗效分析

目的探讨固尔苏（肺泡表面活性物质制剂）预防新生儿呼吸窘迫综合征的疗效。方法将45例同条件早产儿分为两组,观察组21例于生后2h内经气管注入固尔苏;对照组24例未使用固尔苏,比较两组早产儿呼吸窘迫综合征发生率、需要呼吸机治疗的比例、常见并发症的发生率及预后。结果观察组早产儿呼吸窘迫综合征发生率、需要呼吸机治疗的比例及常见并发症的发生率均较对照组减低（P〈0．05）。结论高危早产儿生后应尽早预防性使用固尔苏,可有效降低呼吸窘迫综合征的发病率,减少并发症的发生和呼吸机的应用,提高早产儿生存质量。     

早产儿支气管肺发育不良的高危因素及防治对策

目的研究早产儿支气管肺发育不良的高危因素及防治对策。方法统计2010年1月~2013年12月在我院妇产科出生的早产儿498例的胎龄,出生体重,机械通气参数,是否发生宫内感染,产前或产后是否使用肺泡表面活性物质、肾上腺皮质激素等药物,是否输血,是否发生败血症、动脉导管未关闭以及肺透明膜病等合并症,分析上述指标与早产儿支气管肺发育不良之间的关系。结果早产儿支气管肺发育不良发生率为7.23%。低胎龄、低出生体重、宫内感染、吸入氧气浓度40%、机械通气吸气峰压20 cm H2O、机械通气潮气量6 ml/kg、应用呼吸机3 d、胎龄≤32周且未用使用肾上腺皮质激素及肺泡表面活性物质、输血、未早期喂养、合并症、胎膜早破等为早产儿支气管肺发育不良的高危因素。结论预防感染与早产,使用肾上腺皮质激素及肺泡表面活性物质,早期喂养,于低吸气峰压、低潮气量以及低浓度氧气的前提下机械通气,尽量降低输血量及液体入量,降低并发症发生率等是防治早产儿支气管肺发育不良的对策。     

支气管肺发育不良患儿气管抽吸物单核细胞检测的临床意义研究

目的观察支气管肺发育不良(BPD)患儿气管抽吸物中单核细胞亚型的变化,借此探讨其与BPD的相关性。方法选取我院2018年1月至2019年6月需要机械通气治疗的呼吸窘迫综合征(RDS)早产儿62例,其中BPD组(氧依赖超过28天)24例,对照组38组。流式细胞仪检测患儿气管抽吸物中单核细胞亚型M1和M2所占的比例,ELISA法检测TNF-α、IL-1和IL-10表达。结果两组早产儿气管抽吸物中单核细胞比例差异无显著性(P>0.05),BPD组M1占7.65±1.28%,显著高于对照组的3.57±0.54%(P<0.01),BPD组M2占3.38±0.44%,显著低于对照组的7.35±1.32%(P<0.01)。BPD组早产儿气管抽吸物中TNF-α和IL-1表达显著高于对照组(P<0.01),BPD组IL-10表达显著高于对照组(P<0.01)。结论BPD患者单核细胞M1亚型比例显著升高,M2亚型比例显著减低。     

Blunted peripheral chemoreceptor response to hyperoxia in a group of infants with bronchopulmonary dysplasia

Infants with BPD often suffer from chronic hypoxia and require supplemental oxygen (O₂). This might affect the sensitivity of peripheral chemoreceptors. Therefore, we assessed peripheral chemoreceptor function in 25 infants with bronchopulmonary dysplasia (BPD) of varying severity, using the hyperoxic test. These infants were compared with 35 preterm infants who did not develop BPD. All infants were tested during the 40th week of postconceptional age and their mean postnatal age was 81.5 ± 16.3 days. Sixty percent (15/25) of the BPD infants lacked a hyperoxic response, while the proportion of nonresponders to O₂, among the other groups was 20% (7/35). The intensity of this response was negatively correlated to time spent on a ventilator and positively to time without supplemental oxygen. The intensity of chemoreceptor function was closely related to the severity of BPD; none of the infants with the most severe form of BPD (grade 3) showed a ventilatory response to hyperoxia. Furthermore, infants with BPD needed significantly longer time to increase their saturation than did non-BPD infants (4.7 and 9.3 sec, respectively). We conclude that many infants with BPD, particularly those with the most severe form of the disease, have abnormally functioning peripheral chemoreceptors. Pediatr Pulmonol. 1995; 20:101–106 . © 1995 Wiley-Liss, Inc.     

Long-term pulmonary functional outcome of bronchopulmonary dysplasia and premature birth

Pulmonary function and exercise tolerance were evaluated in late childhood in two groups of prematurely born children: one group with bronchopulmonary dysplasia (BPD) [n] = 15; gestational age at birth (GA): 29.6 ± 2.8 weeks; birth weight (BW): 1,367 ± 548 g; age at test: 7.9 ± 0.6 years, and a second group without significant neonatal lung disease [pre-term (PT)] (n = 9; GA: 30.3 ± 1.7 weeks; BW: 1,440 ± 376 g; age at test: 7.8 ± 0.22 years). The results were compared with a control group of children of similar ages and heights, born at term [term born (TB)]. We observed that total lung resistance (R_L) was significantly higher in BPD (11 ± 3 cmH₂O/L/s), and in PT (9 ± 2) than in TB [5 ± 1; (P < 0.001 and P < 0.05, respectively)]. In BPD R_L was higher than in PT (P < 0.05). Dynamic lung compliance (C_LdY) was decreased in BPD (43 ± 11 mL/cmH₂O) and in PT (56 ± 17) compared with TB (76 ± 20) (P < 0.001 and P < 0.05), and also in BPD compared with PT (P < 0.05). Forced expiratory volume in 1 second (FEV₁) and FEV₁/forced vital capacity (FVC) were lower in BPD (1.07 ± 0.15 L and 72 ± 7%) than in PT (1.29 ± 0.23 L, and 80 ± 7%) (P < 0.05). Exercise tests were performed in six boys with BPD. The ratio between minute ventilation at maximal workload (V_Emax ) and the predicted value of maximal voluntary ventilation (MVV) was elevated in the six BPD boys tested, compared with five boys of Group 2 and five TB boys (87 ± 15% vs. 62 ± 14% and 65 ± 13%) (P < 0.05). We conclude that: (1) prematurity and BPD is followed by long-term airway obstruction and a mild degree of exercise intolerance and; (2) premature birth without BPD may be followed by a milder degree of airway obstruction in childhood than in infants who developed BPD during the neonatal period. Pediatr Pulmonol. 1995; 20:289–296 . © 1995 Wiley-Liss, Inc.     

The value of pulmonary artery acceleration time in evaluating pulmonary vascular disease in preterm infants with bronchopulmonary dysplasia

Objectives

Early screening and dynamic monitoring of pulmonary vascular disease (PVD) in bronchopulmonary dysplasia (BPD) high-risk infants is of great clinical significance. Pulmonary artery acceleration time (PAAT) is a reliable and non-invasive method for assessing PVD in children over 1 year, but to date, few studies have used PAAT to assess pulmonary hemodynamics of preterm infants, especially those with BPD. Through dynamic monitoring the main hemodynamic indicators reflected PVD after birth, this study aimed to assess the value of PAAT in evaluating early PVD in BPD infants.

Methods

All 81 preterm infants at risk of BPD were divided into BPD and non-BPD groups according to whether BPD occurred. Clinical characteristics, PAAT, right ventricular ejection time (RVET) and other main hemodynamic indicators at four different time points after birth were studied and compared.

Results

PAAT and PAAT/RVET increased gradually within 72 h after birth in the BPD group (p < .05), but the curve tended to be flat over time after 72 h (p > .05). At PMA32 and 36 weeks, the PAAT (49.7 ± 4.8 vs. 54.8 ± 5.7, p = .001; 50.0 ± 5.3 vs. 57.0 ± 5.3, p = .001) and PAAT/RVET (.33 ± .04 vs. .35 ± .03, p = .001; .34 ± .03 vs. .37 ± .04, p = .001) in BPD group were significantly lower than those in the non-BPD group.

Conclusions

PAAT and PAAT/RVET in the BPD group infants showed different change patterns compared to non-BPD group infants. PAAT can be used as a noninvasive and reliable screening method for screening and dynamic monitoring of PVD in BPD high-risk infants.     

多潘立酮联合抚触干预早产儿喂养不耐受的临床研究

目的探讨多潘立酮联合抚触治疗早产儿喂养不耐受的临床疗效。方法选择出生时孕周为28～37周早产儿60例,随机分为治疗组32例和对照组28例。两组均给予多潘立酮常规治疗,治疗组在常规治疗基础上增加抚触,观察两组治疗后的效果。结果治疗组的总有效率为90.6%,优于对照组的67.9%（P〈0.05）,治疗后症状减轻、体重恢复亦优于对照组（P〈0.01）。结论多潘立酮联合抚触治疗早产儿喂养不耐受可提高疗效,提高早产儿存活成功率。