极/超低出生体重儿不同程度支气管肺发育不良的临床特点比较  

Comparison of clinical features of different degrees of bronchopulmonary dysplasia in very/extremely low birth weight infants

作　　者：闭宏娟[1] 龙丽娟 黄丽萍[1] 黄谊思 黄增帅[2] 韦秋芬[1] Bi Hongjuan;Long Lijuan;Huang Liping;Huang Yisi;Huang Zengshuai;Wei Qiufen(Department of Neonatology,Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China;Department of Medical Records and Statistics,Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530003,China)

机构地区：[1]广西壮族自治区妇幼保健院新生儿科,南宁530003 [2]广西壮族自治区妇幼保健院病案统计科,南宁530003

出　　处：《中华临床医师杂志（电子版）》2022年第1期66-70,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20200667)。

摘　　要：目的总结极/超低出生体重儿(VLBWI/ELBWI)不同程度支气管肺发育不良(BPD)的临床特点。方法采用回顾性研究,选择2015年7月至2019年1月广西壮族自治区妇幼保健院新生儿科重症监护病房(NICU)住院<32周的VLBWI/ELBWI共202例临床资料,分为非BPD组(45例)、轻度BPD组(36例)、中度BPD组(75例)和重度BPD组(46例)。比较4组患儿一般临床资料、呼吸支持时间及合并症情况。结果影响BPD患儿严重程度的围生期因素包括胎龄、体重、胎膜早破、窒息、产前使用地塞米松、住院天数、氧疗时间(P<0.01)。不同程度BPD患儿吸氧时间、持续气道正压通气(CPAP)时间、机械通气时间及重复上机率差异有统计学意义(P<0.01),其中,重度BPD组患儿重复上机率最高,且需要更长的吸氧、CPAP及机械通气时间。不同程度BPD患儿持续肺动脉高压、解脲支原体感染、早产儿视网膜病变(ROP)等合并症的发生率差异有统计学意义(P<0.05),其中,重度BPD组患儿合并持续肺动脉高压和解脲支原体感染的发生率最高,轻度BPD患儿ROP发生率最高。结论胎龄、体重、胎膜早破、窒息、产前使用地塞米松、住院天数、氧疗时间指标均影响BPD程度,重度BPD患儿合并症多,因此预防早产,缩短氧疗时间,减少重复上机,能够降低BPD程度,减少合并症,提高早产儿生存质量。Objective To summarize the clinical characteristics of different degrees of bronchopulmonary dysplasia(BPD)in very/extremely low birth weight infants(VLBWI/ELBWI).Method A total of 202 VLBWI/ELBWI who were hospitalized at the neonatal intensive care unit(NICU)of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital for<32 weeks from July 2015 to January 2019 were enrolled and divided into non-BPD(45 cases),mild BPD(36 cases),moderate BPD(75 cases),and severe BPD(46 cases)groups.The general clinical data,time of mechanical ventilation,and complications were compared among the four groups.Results The perinatal factors influencing the severity degree of BPD included gestational age,body weight,premature rupture of membranes,asphyxia,prenatal use of dexamethasone,length of hospital stay,and oxygen therapy time(P<0.01).There were statistically significant differences in oxygen inhalation,continuous positive airway pressure(CPAP)usage,mechanical ventilation time,and the rate of repeated use of mechanical ventilation among children with different degrees of BPD(P<0.01).Severe BPD children had the highest repetition rate of mechanical ventilation and required longer time of oxygen intake,noninvasive CPAP usage,or mechanical ventilation.There was a significant difference in the incidence of complications such as persistent pulmonary hypertension,ureaplasma urealyticum infection,and retinopathy of prematurity(ROP)in children with different degrees of BPD(P<0.05).The incidences of persistent pulmonary hypertension and ureaplasma urealyticum infection were the highest in children with severe BPD,and the incidence of ROP was highest in children with mild BPD.Conclusion Gestational age,birth weight,premature rupture of membranes,asphyxia,prenatal use of dexamethasone,length of hospital stay,and oxygen therapy duration are the influencing factors of BPD.Severe BPD children have more complications,and therefore,preventing premature delivery,shortening oxygen therapy time,and reducing repeated machine use can reduce

关 键 词：支气管肺发育不良 极低/超低出生体重儿 正压通气 胎膜早破 

分 类 号：R722.1[医药卫生—儿科]