重度支气管肺发育不良超早产儿综合救治存活1例  

A case of survived extremely preterm infant with severe bronchopulmonary dysplasia after comprehensive therapy

作　　者：高瑞伟 张可 孔维玲 陈超 曹云 周建国 Gao Ruiwei;Zhang Ke;Kong Weiling;Chen Chao;Cao Yun;Zhou Jianguo(Department of Neonatology,National Children's Medical Center(Children's Hospital of Fudan University),Shanghai 201102,China)

机构地区：[1]国家儿童医学中心(复旦大学附属儿科医院)新生儿科,上海201102

出　　处：《中华围产医学杂志》2023年第2期159-163,共5页Chinese Journal of Perinatal Medicine

摘　　要：本文报道了1例重度支气管肺发育不良超早产儿的诊治经过。该患儿胎龄26周+6, 生后61 d不能脱离有创机械通气转入复旦大学附属儿科医院, 入院诊断为重度支气管肺发育不良。予适当限液、改善营养, 糖皮质激素、抗解脲脲原体感染减轻肺实质病变, 降低肺动脉高压等综合治疗。最终拔除气管插管, 无创机械通气逐渐降级, 生后372 d(纠正胎龄9月6 d)高流量鼻导管吸氧出院。出院3月余门诊随访, 生长发育尚可, 肺部影像学明显改善, 高流量鼻导管吸氧的流速和吸氧浓度显著下调。随访至纠正胎龄1岁11个月, 完全离氧, 语言运动发育落后, 康复训练中。This article reported the comprehensive management of an extremely preterm infant with severe bronchopulmonary dysplasia.The patient born at 26+6 gestational weeks was transferred to Children's Hospital of Fudan University due to invasive mechanical ventilation dependence at 61 d after birth and was diagnosed with severe bronchopulmonary dysplasia.A comprehensive treatment plan was adopted,including appropriate fluid restriction,improving nutrition,glucocorticoid administration,using antibiotics against Ureaplasma urealyticum infection to reduce pulmonary parenchymal lesions and alleviating pulmonary hypertension.The preterm infant was successfully extubated to non-invasive ventilation and subsequently weaned to a high-flow nasal cannula.Then,the patient was discharged at 372 d after birth(correct gestational age nine months and six days).At the 3-month follow-up after discharge,the patient remained on high-flow oxygen,but with lower flow and concentration of oxygen.Moreover,the growth,development and lung images were significantly improved.Follow-up to correct gestational age one year and 11 months,the child was not on oxygen any more,but on rehabilitation due to language and motor development retardation.

关 键 词：支气管肺发育不良 糖皮质激素类 解脲支原体 胃造口术 综合疗法 婴儿 早产 

分 类 号：R722.6[医药卫生—儿科]