呼吸窘迫综合征并发支气管肺发育不良危险因素分析  

Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome

作　　者：陈幽[1] 韩玉昆[2] 叶贞志[1] 卢光进[1] 

机构地区：[1]深圳市宝安区妇幼保健院新生儿科,广东深圳518133 [2]中国医科大学第二附属医院,辽宁沈阳110004

出　　处：《中国当代儿科杂志》2007年第1期15-18,共4页Chinese Journal of Contemporary Pediatrics

摘　　要：目的探讨呼吸窘迫综合征(RDS)患儿支气管肺发育不良(BPD)的危险因素。方法对该院2000年1月至2005年8月应用呼吸机治疗并住院28d以上的呼吸窘迫综合征患儿进行回顾性分析,比较并综合分析20余种高危因素与BPD的关系。结果72例呼吸机治疗、住院>28d呼吸窘迫综合征患儿BPD发生率为23.6%(17/72),BPD组FiO2,PIP,PEEP,MAP,上机日龄、产前应用地塞米松促肺成熟、生后应用肺表面活性物质(PS)等与对照组差异无显著性(P>0.05),而胎龄≤30周、出生体重≤1250g、上机次数≥2次、合并肺炎、肺出血、上机天数≥5d、痰培养阳性2次以上等与对照组差异有显著性(P<0.05);多因素Logistic回归显示出生体重≤1250g、机械通气≥10d,痰培养阳性3次以上为发生BPD的独立危险因素。结论避免低体重早产儿、缩短应用机械通气时间、防止及减少肺部感染,尤其是严重感染是预防RDS发生BPD的重要措施。Objective To identify the risk factors for bronchopulmonary dysplasia （BPD） in neonates with respiratory distress syndrome （RDS）. Methods Data from 72 patients with RDS （ birth weight 1 607 ±277 g; gestational age 29.47 ±2.54 weeks）who were hospitalized for 〉 28 days and who received mechanical ventilation treatment between January 2001 and August 2005 were studied retrospectively. A logistic regression analysis was used to identify the risk factors associated with the development of BPD. Results Of the 72 patients, 17 developed BPD （23.6%）. Uniovariate analysis revealed that in addition to a gestational age of ≤ 30 weeks and a birth weight below 1 250 g, the times of mechanical ventilation treatment （ ≥ 2 times） , concurrent pulmonary infection and pneumorrhagia, prolonged mechanical ventilation （ ≥5 days） , and positive sputum bacterial cultures on 2 occasions were all associated with an increase in the incidence of BPD. Multivariate logistic analysis revealed that birth weight below 1 250 g, prolonged mechanical ventilation （ ≥10 days） ,and positive sputum cultures on 3 or more occasions were independent risk factors for BPD （ OR = 6.614,14. 997and 39.752 respectively）. Conclusions The risk for BPD is multifactorial. Preventing small gestational age and low birth weight prematurity, decreasing the duration of mechanical ventilation and treatment of pulmonary infection are necessary to prevent BPD.

关 键 词：呼吸窘迫综合征 支气管肺发育不良 危险因素 新生儿 

分 类 号：R722[医药卫生—儿科]