CAJ | 학술논문

目的：分析不同程度早产儿支气管肺发育不良(BPD)的高危因素，指导该病的临床防治。方法收集2011年2月~2014年2月在我院新生儿科住院并确诊为 BPD 的128例早产儿的临床资料，按 BPD 的严重程度分为轻度、中度、重度三组，对各组的资料进行比较分析。结果轻度、中度、重度 BPD 组分别纳入患儿57例、45例、26例，各组患儿在性别、胎次、分娩方式、母患妊高征、产前应用激素、有否胎儿窘迫、出生复苏、肺表面活性物质应用、合并肺出血等方面的差异无统计学意义(P >0.05)；随着 BPD 程度的加重，胎龄和出生体重呈下降趋势，阿氏评分1 min<8分、胎膜早破>12 h、母亲孕期合并感染、羊水胎粪污染的比例上升(P <0.05)；用氧时间、输浓缩红细胞(CRBC)、血和痰培养阳性、合并 PDA 以及侵入性治疗(机械通气、气管插管超过2次、插胃管)等方面的比例渐增大，差异有统计学意义(P <0.05)。结论避免早产低出生体重是预防 BPD 的基础，积极防治感染、缩短气管插管机械通气和用氧的时间是减轻 BPD 严重程度的关键措施。
목적：분석불동정도조산인지기관폐발육불량(BPD)적고위인소，지도해병적림상방치。방법수집2011년2월~2014년2월재아원신생인과주원병학진위 BPD 적128례조산인적림상자료，안 BPD 적엄중정도분위경도、중도、중도삼조，대각조적자료진행비교분석。결과경도、중도、중도 BPD 조분별납입환인57례、45례、26례，각조환인재성별、태차、분면방식、모환임고정、산전응용격소、유부태인군박、출생복소、폐표면활성물질응용、합병폐출혈등방면적차이무통계학의의(P >0.05)；수착 BPD 정도적가중，태령화출생체중정하강추세，아씨평분1 min<8분、태막조파>12 h、모친잉기합병감염、양수태분오염적비례상승(P <0.05)；용양시간、수농축홍세포(CRBC)、혈화담배양양성、합병 PDA 이급침입성치료(궤계통기、기관삽관초과2차、삽위관)등방면적비례점증대，차이유통계학의의(P <0.05)。결론피면조산저출생체중시예방 BPD 적기출，적겁방치감염、축단기관삽관궤계통기화용양적시간시감경 BPD 엄중정도적관건조시。
Objective To analyze the risk factors of different severities bronchopulmonary dysplasia (BPD)in preterm infants and to guide this disease clinical prevention and treatment. Methods The clinical records of 128 preterm infants with different severities BPD,who were admitted to NICU from Feb.201 1 to Feb.2014,were collected and were assigned to one of the 3 groups (mild,moderate,severe)based on BPD se-verities.Statistical analysis of every data set was performed. Results Mild,moderate and severe BPD groups had 57,45 and 26 cases,respectively.Comparisons gender,birth delivery times,birth delivery methods,ges-tational hypertension,use of prenatal Corticosteroids,fetal distress,resuscitation of newborn,use of pulmona-ry surfactant and pulmonary hemorrhage complication among three groups were performed and there were no statistically significant differences (P >0.05).The birth weights and gestational age decreased with the in-creasing severity of BPD,meanwhile the incidence of Apgar 1 minute score <8,premature rupture of mem-branes > 12 hours,infection in pregnancy period,meconium contamination of the amniotic fluid were in-creased,there were statistically significant differences (P <0.05).With disease worsening,longer duration of oxygen uptake,transfusion of more concentrated red blood cells,positive rates of hemoculture and sputum cul-ture specimen,more patent ductus arteriosus complications and more invasiveness therapy (mechanical ventila-tion,tracheal intubation twice or more,and nasogastric intubation)occurred,group-paired comparison yiel-ded statistically significant differences (P <0.05). Conclusion Avoidance of premature delivery,low birth weight newborn is the basis of prevention BPD.The key interventions for reducing the severity of BPD are pre-vention and therapy of infection,shortening the time of mechanical ventilation and oxygen uptake.