极早和超早产儿支气管肺发育不良严重程度危险因素分析  

Risk factors for the severity of bronchopulmonary dysplasia in very and extremely preterm infants

作　　者：高琦[1] 蒋海燕[2] 何海英[2] 刘利军[2] GAO Qi;JIANG Haiyan;HE Haiying;LIU Lijun(Baotou Medical College,Baotou 014010,China)

机构地区：[1]包头医学院,内蒙古包头014010 [2]包钢集团第三职工医院新生儿科,内蒙古包头014010

出　　处：《中国中西医结合儿科学》2021年第6期500-503,共4页Chinese Pediatrics of Integrated Traditional and Western Medicine

基　　金：包头市科技计划项目(2017S2001-2-2)。

摘　　要：目的探索影响新生儿重症监护病房极早和超早产儿支气管肺发育不良(BPD)严重程度的危险因素,为防治不同程度的BPD提供理论依据。方法应用回顾性分析的研究方法,收集2013年12月至2018年12月我院新生儿重症监护病房收治诊断为BPD的胎龄<32周129例极早和超早产儿的临床资料,根据临床诊断标准分为Ⅰ度BPD组(33例)、Ⅱ度BPD组(55例)、Ⅲ度BPD组(41例),通过单因素分析比较组间孕母情况、患儿出生情况、并发症及治疗措施,对单因素分析有统计学意义的因素进行多因素有序Logistic回归分析,探索影响极早和超早产儿BPD严重程度的独立危险因素。结果单因素分析比较3组患儿出生体质量、肺出血、宫外生长发育迟缓、吸氧浓度>40%、输血次数≥3次、是否高频有创机械通气及有创机械通气时间差异有统计学意义,多因素有序Logistic回归分析得出,肺出血(OR=9.207,95%CI:0.151~4.289)、有创机械通气时间(OR=1.110,95%CI:0.021~0.188)是极早和超早产儿BPD严重程度的独立危险因素。结论极早和超早产儿发生BPD的严重程度与多因素有关,肺出血、有创机械通气时间是极早和超早产儿BPD严重程度的独立危险因素。积极预防肺出血和减少有创机械通气时间是降低BPD严重程度的重要措施。Objective To explore the risk factors affecting the severity of bronchopulmonary dysplasia(BPD)in very and extremely preterm infants in neonatal intensive care unit(NICU),and to provide theoretical evidence for the prevention and treatment of different degrees of BPD.Methods The research method of retrospective analysis was applied.The clinical data of 129 very and extremely preterm infants with gestational age<32 weeks diagnosed with BPD in neonatal intensive care unit of our hospital from December 2013 to December 2018 were collected,and the infants were divided into grade Ⅰ BPD(33 cases),grade Ⅱ BPD(55 cases)and grade Ⅲ BPD(41 cases)according to the clinical diagnostic criteria.Univariate analysis was used to compare the maternal status,birth status,complications and treatment measures.To explore the independent risk factors influencing the severity of bronchopulmonary dysplasia in very and extremely preterm infants,multivariate Logistic regression analysis was used to analyze the significant factors of univariate analysis.Results Univariate analysis showed that there were statistically significant difference in birth weight,pulmonary hemorrhage,extrauterine growth retardation,oxygen inhalation concentration>40%,blood transfusion≥3 times,high frequency invasive mechanical ventilation and invasive mechanical ventilation time among the three groups.Multivariate Logistic regression analysis showed that pulmonary hemorrhage(OR=9.207,95%CI:0.151~4.289)and invasive mechanical ventilation time(OR=1.110,95%CI:0.021~0.188)were independent risk factors for BPD severity in very and extremely preterm infants.Conclusion The severity of BPD in very and extremely preterm infants is related to multiple factors.Pulmonary hemorrhage and invasive mechanical ventilation time are independent risk factors for BPD severity in very and extremely preterm infants.Prevention of pulmonary hemorrhage and reduction of invasive mechanical ventilation time are important measures to reduce the severity of BPD.

关 键 词：支气管肺发育不良 严重程度 极早产儿 超早产儿 危险因素 

分 类 号：R725.6[医药卫生—儿科]