临床肺科杂志
臨床肺科雜誌
림상폐과잡지
JOUNAL OF CLINICAL PULMONARY MEDICINE
2015年
1期
92-94,95
,共4页
彭磊%乐功芳%陈绪萍%龚益明
彭磊%樂功芳%陳緒萍%龔益明
팽뢰%악공방%진서평%공익명
早产儿支气管肺发育不良%高危因素%防治对策
早產兒支氣管肺髮育不良%高危因素%防治對策
조산인지기관폐발육불량%고위인소%방치대책
preterm infants with bronchopulmonary dysplasia%high risk factors%countermeasures
目的：研究早产儿支气管肺发育不良的高危因素及防治对策。方法统计2010年1月~2013年12月在我院妇产科出生的早产儿498例的胎龄，出生体重，机械通气参数，是否发生宫内感染，产前或产后是否使用肺泡表面活性物质、肾上腺皮质激素等药物，是否输血，是否发生败血症、动脉导管未关闭以及肺透明膜病等合并症，分析上述指标与早产儿支气管肺发育不良之间的关系。结果早产儿支气管肺发育不良发生率为7．23%。低胎龄、低出生体重、宫内感染、吸入氧气浓度>40%、机械通气吸气峰压>20 cmH2 O、机械通气潮气量>6 ml/kg、应用呼吸机>3 d、胎龄≤32周且未用使用肾上腺皮质激素及肺泡表面活性物质、输血、未早期喂养、合并症、胎膜早破等为早产儿支气管肺发育不良的高危因素。结论预防感染与早产，使用肾上腺皮质激素及肺泡表面活性物质，早期喂养，于低吸气峰压、低潮气量以及低浓度氧气的前提下机械通气，尽量降低输血量及液体入量，降低并发症发生率等是防治早产儿支气管肺发育不良的对策。
目的：研究早產兒支氣管肺髮育不良的高危因素及防治對策。方法統計2010年1月~2013年12月在我院婦產科齣生的早產兒498例的胎齡，齣生體重，機械通氣參數，是否髮生宮內感染，產前或產後是否使用肺泡錶麵活性物質、腎上腺皮質激素等藥物，是否輸血，是否髮生敗血癥、動脈導管未關閉以及肺透明膜病等閤併癥，分析上述指標與早產兒支氣管肺髮育不良之間的關繫。結果早產兒支氣管肺髮育不良髮生率為7．23%。低胎齡、低齣生體重、宮內感染、吸入氧氣濃度>40%、機械通氣吸氣峰壓>20 cmH2 O、機械通氣潮氣量>6 ml/kg、應用呼吸機>3 d、胎齡≤32週且未用使用腎上腺皮質激素及肺泡錶麵活性物質、輸血、未早期餵養、閤併癥、胎膜早破等為早產兒支氣管肺髮育不良的高危因素。結論預防感染與早產，使用腎上腺皮質激素及肺泡錶麵活性物質，早期餵養，于低吸氣峰壓、低潮氣量以及低濃度氧氣的前提下機械通氣，儘量降低輸血量及液體入量，降低併髮癥髮生率等是防治早產兒支氣管肺髮育不良的對策。
목적：연구조산인지기관폐발육불량적고위인소급방치대책。방법통계2010년1월~2013년12월재아원부산과출생적조산인498례적태령，출생체중，궤계통기삼수，시부발생궁내감염，산전혹산후시부사용폐포표면활성물질、신상선피질격소등약물，시부수혈，시부발생패혈증、동맥도관미관폐이급폐투명막병등합병증，분석상술지표여조산인지기관폐발육불량지간적관계。결과조산인지기관폐발육불량발생솔위7．23%。저태령、저출생체중、궁내감염、흡입양기농도>40%、궤계통기흡기봉압>20 cmH2 O、궤계통기조기량>6 ml/kg、응용호흡궤>3 d、태령≤32주차미용사용신상선피질격소급폐포표면활성물질、수혈、미조기위양、합병증、태막조파등위조산인지기관폐발육불량적고위인소。결론예방감염여조산，사용신상선피질격소급폐포표면활성물질，조기위양，우저흡기봉압、저조기량이급저농도양기적전제하궤계통기，진량강저수혈량급액체입량，강저병발증발생솔등시방치조산인지기관폐발육불량적대책。
Objective To analyze the risk factors and prevention countermeasures in preterm infants with bronchopulmonary dysplasia. Methods The related paraments of 498 premature infants were statistically collected, including gestational age, birth weight, mechanical ventilation, intrauterine infection, using pulmonary surfactant prenatally or postnatally, adrenal cortical hormone drugs, blood transfusion, sepsis, closure of artery catheter and hy-aline membrane disease and other comorbidities. The relationship between the indexes and preterm infants with bron-chopulmonary dysplasia was analyzed. Results The incidence of preterm infants with bronchopulmonary dysplasia was 7. 23%. The high risk factors included low gestational age, low birth weight, intrauterine infection, the inhala-tion of oxygen concentration >40%, the peak inspiratory pressure of mechanical ventilation >20 cmH2 O, mechani-cal ventilation tidal volume >6ml/kg, application of ventilator >3D, gestational age≤32 weeks and not use the ad-renal cortex hormone and pulmonary surfactant, blood transfusion, delayed feeding, complications, and premature rupture of membranes break. Conclusion The countermeasures to prevent preterm infants with bronchopulmonary dysplasia include the prevention of infection and premature delivery, adrenal cortical hormone and pulmonary surfac-tant, the use of early enteral feeding, mechanical ventilation under the low peak inspiratory pressure, low volume and low concentration of oxygen, and reducing the amount of blood transfusion and liquid intake.
