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目的了解早产儿支气管肺发育不良(BPD)的临床特点。方法2003-09—2006-12在温州医学院附属育英儿童医院收住1325例早产儿,对其胎龄、出生体重、原发疾病、肺部X线表现、治疗经过等临床资料进行分析。结果1325例早产儿中17例发生BPD,胎龄<28周4例,28～30周4例,～32周4例,34周1例,4例不详;出生体重<1000g4例,1000～1500g4例,～2500g4例,>2500g2例,2例不详;轻度BPD10例,中度BPD4例,重度BPD3例;需要机械通气时间为(29.7±14.2)d,需吸氧时间为(35.2±15.4)d,吸入氧体积分数>0.60时间为(97.3±11.4)h,住院时间为(45.6±49.9)d。所有病例均合并肺部感染,经综合治疗自动出院4例,死亡2例,治愈1例,好转10例,好转患儿均因肺部感染再次住院。结论早产儿肺发育不成熟、长时间吸氧及机械通气、肺部感染是BPD发生的主要因素,应加强对BPD的早期诊断及合理的综合治疗措施。
Objective To understand the clinical features of bronchopulmonary dysplasia (BPD) in preterm infants. Methods A total of 1325 preterm infants were admitted to Yuying Children ’s Hospital of Wenzhou Medical College from September 2003 to December 2006, and their clinical data such as gestational age, birth weight, primary disease, pulmonary X - ray findings and treatment were analyzed. Results Among 1325 preterm infants, BPD occurred in 17 cases, gestational age was less than 28 weeks in 4 cases, 28 to 30 weeks in 4 cases, 32 weeks in 4 cases, 34 weeks in 1 case, 4 cases were unknown; birth weight <1000g in 4 cases, 1000 ~ 1500g4 (2 cases of ~ 2500g in 2 cases, 2 cases of unknown; mild BPD in 10 cases, moderate BPD in 4 cases, severe BPD in 3 cases; the need for mechanical ventilation was (29.7 ± 14.2) d, oxygen inhalation time was (35.2 ± 15.4) d, inhalation oxygen volume fraction> 0.60 time was (97.3 ± 11.4) h, hospital stay was (45.6 ± 49.9) days. All cases were complicated with pulmonary infection. Four patients were discharged automatically after comprehensive treatment. Two patients died, one patient was cured and 10 patients improved. All the patients who improved were hospitalized again due to pulmonary infection. Conclusions Immature pulmonary development, long-term oxygen inhalation and mechanical ventilation, and lung infection are the main factors of BPD in preterm infants. Early diagnosis of BPD and reasonable comprehensive treatment should be strengthened.