早产儿支气管肺发育不良的危险因素分析

目的探讨早产儿支气管肺发育不良（BPD）的危险因素,为BPD的临床防治提供理论参考。方法回顾分析2011年1月-2014年1月在成都市妇女儿童中心医院新生儿科住院、胎龄在34周以内、生存28d以上的621例早产儿资料。以BPD的发生与否分为BPD组与非BPD组,并对多种危险因素与BPD的发生进行统计学分析。结果早产儿BPD发生率为15.9%。胎龄、低出生体质量及并发出生5min窒息、肺炎、肺出血、呼吸机相关性肺炎、呼吸急性窘迫综合征、呼吸机治疗、肺动脉高压、贫血、宫内发育迟缓、败血症、产前感染、高浓度吸氧、其母有产前感染性疾病与BPD发生有关,其中胎龄、低出生体质量、高浓度吸氧、呼吸机治疗、呼吸机相关性肺炎、败血症、产前感染、发育迟缓是BPD的独立危险因素。结论保证胎儿宫内正常生长发育、尽可能避免早产、减少感染、合理应用机械通气以减少肺部并发症是预防早产儿发生BPD的重要措施。

An Analysis of Risk Factors of the Bronchopulmonary Dysplasia of Premature Infants

Objective To discuss risk factors of the BPD of premature infants, and to provide theoretic refer- ences for the clinical prevention and treatment of BPD. Method To make a retrospective analysis of the data of the 621 cases of premature infants with gestational ages under 34 weeks and survival rate over 28 d at birth hospitalized at the Newborns Department of Chengdu Central Hospital of Women and Children from January 2011 to January 2014, divide them into BPD group and Non-BPD group factually, and conduct a statistical a- nalysis of the numerous risk factors and the occurrence of BPD. Results The rate of BPD occurrence for pre mature infants was 15.9 %. The various risk factors contributing to the occurrence of BPD included gestational age, birth weight, complications such as 5 min asphyxia, pneumonia, bleeding in the lungs, VAP, ARDS, ventilator treatment, PAH, anemia, IUGR, sepsis, prenatal infection, high concentration of oxygen, and in- fectious disease carrying mothers, among which gestational age, low birth weight, high concentration of oxy gen, ventilator treatment, VAP, sepsis, prenatal infection, and growth retardation were independent risk fac tors of BPD. Conclusion To ensure a normal intrauterine growth of fetus, try to prevent the premature birth, reduce chances for infections, and reduce the rates for lung implications through a rational application of me- chanic ventilation are important measures of preventing the BPD of premature infants.