极低出生体重儿支气管肺发育不良高危因素分析

目的研究极低出生体重儿支气管肺发育不良(BPD)的危险因素。方法对四川大学华西第二医院2008年8月～2011年8月收治的241例极低出生体重儿进行回顾性研究,将其分为BPD组(31例)与非BPD组(210例),从产前及出生情况、生后治疗及合并症等方面对照,探讨BPD发生的危险因素。结果极低出生体重儿BPD发生率为12.9%,BPD组出生体重及孕周均较非BPD组低(P<0.001),母亲产前感染史、新生儿呼吸窘迫综合征(NRDS)的发生率、机械通气及用氧时间较非BPD组升高(P<0.01)。BPD组肺出血、颅内出血、早产儿视网膜病(ROP)等合并症的发生率均高于非BPD组(P<0.05)。Logistic回归分析得出孕周<30周(OR 5.033,P<0.01)及NRDS(OR 4.060,P<0.05)是BPD发生的高危因素。结论低胎龄及NRDS是BPD发生的高危因素,而低出生体重、母亲产前感染史、机械通气及用氧时间也与BPD发生有关。提示通过预防早产、预防孕妇感染、采取保护性通气策略可能降低BPD发生率。

Risk factors in bronchopulmonary dysplasia of very-low-birth-weight infants

Objective To study the high-risk factors and prevention for bronchopulmonary dysplasia(BPD) in very-low-birth-weight infants.Methods A retrospective study was conducted at West China Second University Hospital to evaluate the risk factors associated with BPD in very-low-birth-weight.From August 2008 to August 2011,two hundred and forty-one very low birth weight infants were admitted in our NICU.Thirty-one infants with BPD were compared to two hundred and ten ones without BPD in the neonatal and maternal risk factors,treatment and complications.Results The incidence of BPD in the very low birth weight infants was 12.9%.The gestational age and birth weight of BPD group were lower than those without BPD,and the rates of infection during pregnancy in BPD group were higher than those without.The incidence of neonatal respiratory distress syndrome(NRDS),pulmonary hemorrhage,intracranial hemorrhages(ICH),retinopathy of prematurity(ROP) in BPD group were higher than those without(P<0.05).The time of mechanical ventilation and oxygen administration were longer in BPD group(P<0.001).Logistic regression analysis indicates that gestational age<30 weeks(OR 5.033,P<0.01) and NRDS(OR 4.060,P<0.05) significantly increase the risk for BPD.Conclusion Preventing premature labor and infection of pregnant woman, using lung protective strategies of ventilation might be means to prevent BPD in these infants.