早产儿支气管肺发育不良临床高危因素及防治策略

摘要

目的 探讨早产儿支气管肺发育不良的高危因素,为临床本病防治策略的制定提供理论依据.方法 回顾性分析2013年6月至2015年6月我院收治的172例早产新生儿的临床资料.将发生支气管肺发育不良的40例患儿分为病例组,将未发生支气管肺发育不良的132例患儿分为对照组.对比两组患儿的各项临床资料,并通过Logistic逐步回归分析探讨早产儿支气管肺发育不良发生的高危因素.结果 病例组的胎龄、出生体重、出生第1天血红蛋白均显著低于对照组,而1 min Apgar评分≤7、发生宫内感染、发生新生儿呼吸窘迫综合征、发生动脉导管未闭、发生肺出血、发生巨细胞病毒感染、使用肺表面活性物质、接受有创机械通气治疗、有创机械通气≥7d、接受手术治疗、最高吸入氧体积分数≥400 ml/L以及出生2周内接受红细胞输注的比例均显著高于对照组(P＜0.05);Logistic逐步回归分析结果显示,胎龄、出生体重、巨细胞病毒感染、有创机械通气≥7d、最高吸入氧体积分数≥400 ml/L、接受手术治疗以及出生2周内接受红细胞输注均是早产儿发生支气管肺发育不良的危险因素(P＜0.05).结论 早产儿支气管肺发育不良的发病是由多种因素促成,临床应针对本病发病的高危因素,制定防治措施,降低患儿的发病风险,改善患儿的预后.%Objective To investigate the risk factors of bronchopulmonary dysplasia in preterm infants,and to provide a theoretical basis for the development of clinical disease prevention strategies.Methods 172 premature infants in our hospital from June 2013 to June 2015 were selected,in whom 40 children with bronchopulmonary dysplasia were divided into case group,132 children without bronchopulmonary dysplasia were divided into control group.Compared the clinical data of two groups,and investigated risk factors of bronchopulmonary dysplasia in preterm infants through Logistic regression analysis.Results Gestational age,birth weight,hemoglobinon on the first day after birth in case group were significantly lower than those in control group,the rates of 1 min Apgar score equal to or less than 7,intrauterine infection,neonatal respiratory distress syndrome,patent ductus arteriosus,pulmonary bleeding,cytomegalovirus infection,the usage of pulmonary surfactant,receiving invasive mechanical ventilation treatment,the time of invasive mechanical ventilation equal to 7 d or above,surgical treatment,the highest inhaled oxygen volume fraction greater than or equal to 400 ml/L,receiving erythrocyte transfusion within 2 weeks after birth were significantly higher than those in control group (P＜0.05);Logistic regression analysis showed that gestational age,birth weight,cytomegalovirus infection,the time of invasive mechanical ventilation equal to 7 d or above,the highest inhaled oxygen volume fraction greater than or equal to 400 ml/L,surgical treatment,receiving erythrocyte transfusion within 2 weeks after birth were all risk factors of bronchopulmonary dysplasia in preterm infants (P＜0.05).Conclusions The incidence of bronchopulmonary dysplasia in preterm infants is caused by a variety of factors;in allusion to clinical risk factors for the onset of the disease,we should set out prevention and control measures to reduce the risk of the disease and improve the prognosis.