摘要
目的探讨极低出生体质量患儿支气管肺发育不良(BPD)的临床特点及危险因素。方法选取南阳市第一人民医院2017年9月-2018年10月极低出生体质量患儿120例,根据是否发生BPD分为BPD组52例与非BPD组68例。回顾性分析两组患儿的临床资料,分析BPD发生的危险因素及临床特点,随访1年对比两组患儿肺功能及预后情况。结果BPD组胎龄、出生体质量、Apgar评分、并发症发生情况、患儿机械通气时间、静脉营养时间、输血次数、患儿吸氧时间及母亲合并绒毛膜羊膜炎的比例与非BPD组比较,差异有显著性(t=2.404~17.338,χ^(2)=4.482~10.141,P<0.05)。患儿出生体质量<1300 g、动脉导管未闭、机械通气时间及母亲合并绒毛膜羊膜炎为BPD发生的独立危险因素(OR=2.324~3.653,P<0.05);随访1年显示,BPD组肺功能指标吸呼比、达峰容积比、达峰时间比、潮气量/体质量比低于非BPD组,呼吸频率大于非BPD组(t=4.909~8.819,P<0.05),且BPD组肺炎发生次数、喘息发作次数及住院次数多于非BPD组(t=11.126~14.180,P<0.05)。结论患儿极低出生体质量、动脉导管未闭、母亲合并绒毛膜羊膜炎、患儿机械通气时间均为BPD发生的独立危险因素,临床应积极采取合理措施,规避危险因素,促进患儿肺功能改善。
Objective To investigate the clinical features of very-low-birth-weight infants with bronchopulmonary dysplasia(BPD)and related risk factors.Methods A total of 120 very-low-birth-weight infants who were born in Nanyang First People’s Hospital from September 2017 to October 2018 were enrolled,and according to the presence or absence of BPD,they were divided into BPD group with 52 infants and non-BPD group with 68 infants.A retrospective analysis was performed for the clinical data of the two groups to investigate the risk factors for BPD and the clinical features of BPD,and the two groups were followed up for 1 year to compare pulmonary function and prognosis.Results There were significant differences between the BPD group and the non-BPD group in gestational age,birth weight,Apgar score,incidence rate of complications,duration of mechanical ventilation,duration of parenteral nutrition,number of times of blood transfusion,duration of oxygen inhalation,and proportion of infants whose mothers had chorioamnionitis(t=2.404-17.338,χ^(2)=4.482-10.141,P<0.05).Birth weight<1300 g,patent ductus arteriosus,duration of mechanical ventilation,and maternal chorioamnionitis were independent risk factors for BPD(OR=2.324-3.653,P<0.05).The 1-year follow-up showed that compared with the non-BPD group,the BPD group had significantly lower pulmonary function parameters of inspiratory/expiratory ratio,ratio of volume to peak tidal expiratory flow to total expiratory volume,ratio of time to peak tidal expiratory flow to total expiratory time,and tidal volume/body weight ratio and a significantly higher respiratory rate(t=4.909-8.819,P<0.05),as well as significantly higher numbers of times of pneumonia,asthma attacks,and hospitalization(t=11.126-14.180,P<0.05).Conclusion Very low birth weight,patent ductus arteriosus,the mother with chorioamnionitis,and duration of mechanical ventilation are independent risk factors for BPD,and reasonable mea-sures should be taken to avoid risk factors and promote the improvement in pulmonary function in children.
作者
张金玉
许俊
张红阳
ZHANG Jinyu;XU Jun;ZHANG Hongyang(Neonatal Intensive Care Department,Nanyang First People’s Hospital,Nanyang 473000,China)
出处
《精准医学杂志》
2022年第6期523-526,530,共5页
Journal of Precision Medicine
关键词
婴儿
极低出生体质量
婴儿
早产
支气管肺发育不良
动脉导管未闭
绒毛膜羊膜炎
呼吸功能试验
体征和症状
危险因素
预后
Infants,extremely low birth weight
Babies,premature
Bronchopulmonary dysplasia
Ductus arteriosus,patent
Chorioamnionitis
Respiratory function test
Signs and symptoms
Risk factors
Prognosis
