早产儿中重度支气管肺发育不良与出生后早期动脉血气值的相关性  

The relationship between early postnatal arterial blood values and moderate and severe bronchopulmonary dysplasia in preterm infants

作　　者：韩晓雅 赵益伟 缪晓林[1] 崔曙东[1] HAN Xiao-ya;ZHAO Yi-wei;MIAO Xiao-lin;CUI Shu-dong(Department of Pediatrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;Department of Pediatrics,Yueqing Municipal People’s Hospital,Yueching 325600,Zhejiang,China)

机构地区：[1]南京医科大学第一附属医院儿科,南京210029 [2]乐清市人民医院儿科,乐清325600

出　　处：《中国临床医学》2022年第2期213-217,共5页Chinese Journal of Clinical Medicine

基　　金：江苏省妇幼健康重点学科(FXK201730)。

摘　　要：目的探讨胎龄小于32周早产儿中重度支气管肺发育不良(bronchopulmonary dysplasia,BPD)与生后早期动脉血pH值、PaO_(2)及PaCO_(2)的相关性。方法收集2017年1月至2019年12月南京医科大学第一附属医院新生儿病房胎龄小于32周的236例早产儿的临床资料,其中54例中重度BPD为BPD组,其余为对照组。分析早产儿生后1周内动脉血pH值、PO_(2)及PCO_(2)与中重度BPD的关系。结果出生后第1天,BPD组pH值显著低于对照组[(7.25±0.12)vs(7.31±0.09),P=0.001];出生后第7天,BPD组PaO_(2)显著低于对照组[(63.20±23.75)mmHg vs(75.91±20.70)mmHg,1 mmHg=0.133 kPa,P<0.001],PaCO_(2)显著高于对照组[(43.59±9.87)mmHg vs(38.26±9.11)mmHg,P<0.001]。除了低胎龄、低出生体质量和机械通气外,出生后第1天的低pH值和第7天的低PaO_(2)是中重度BPD的独立危险因素。结论早产儿生后早期低pH值和低PaO_(2)可能影响中重度BPD进展。Objective To study the relationship between arterial blood pH,PaO_(2),and PaCO_(2)in the first week after birth and moderate and severe bronchopulmonary dysplasia(BPD)in preterm infants.Methods A cohort of 236 consecutive preterm infants with<32 gestational weeks were selected from January of 2017 to December of 2019,54 infants with moderate and severe BPD were identified as the study group and the other as the control group.Early blood gas values and clinical characteristics were collected and analyzed.Results Compared with the control group,significantly lower pH([7.25±0.12]vs[7.31±0.09],P=0.001)of 1st day,lower PaO_(2)([63.20±23.75]mmHg vs[75.91±20.70]mmHg,P<0.001),higher PaCO_(2)([43.59±9.87]mmHg vs[38.26±9.11]mmHg,1 mmHg=0.133 kPa,P<0.001)of 7th day occurred in the study group.Lower pH of 1st day and lower PaO_(2)of 7th day after birth were the independent risk factors of moderate and severe BPD besides lower gestational age,lower birth weight,and mechanical ventilation.Conclusions The early hypoxia and acidosis after birth may affect the progress of moderate and severe BPD.

关 键 词：支气管肺发育不良 血气紊乱 早产儿 危险因素 

分 类 号：R722.6[医药卫生—儿科]