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目的对早产儿支气管肺发育不良(BPD)的发生率及转归情况进行调查研究,分析BPD发生的危险因素及防治对策。方法选取2004年6月-2014年6月在该院新生儿重症监护室(NICU)中住院时间≥28 d,胎龄≤34周的早产儿582例为研究对象,根据是否发生BPD分为BPD组(200例)和对照组(382例),收集患儿临床一般资料及预后转归情况,分析BPD发生的相关因素并进行多元回归分析。结果 200例(34.36%)BPD早产儿中,轻度59例,中度103例,重度38例;11例在治疗过程中死亡,2例在随访过程中死亡,总病死率为6.50%(13/200);多因素分析显示生体时体重(OR=0.769,P<0.05)与1min Apgar评分(OR=0.831,P<0.05)是BPD发生的保护性因素,即体重和1 min Apgar评分越高,早产儿发生BPD的危险性越低;呼吸机相关性肺炎(OR=6.397,P<0.05)、视网膜病(OR=3.121,P<0.05)与动脉导管未闭(PDA)(OR=2.973,P<0.05)则是早产儿发生BPD的危险因素。结论 BPD患儿的病死率高,临床上积极预防呼吸机相关性肺炎、视网膜病及PDA的发生能够降低BPD的发生率,降低早产儿的死亡率。
Objective To investigate the incidence and prognosis of bronchopulmonary dysplasia (BPD) in premature infants, and to analyze the risk factors and prevention and cure measures of BPD. Methods From June 2004 to June 2014, 582 preterm infants with ≥28 days of hospital stay in neonatal intensive care unit (NICU) were enrolled in this study. According to whether there was BPD or not, (200 cases) and control group (382 cases). The general clinical data and prognosis of children were collected. The related factors of BPD were analyzed and multivariate regression analysis was performed. Results Among 200 cases (34.36%) of preterm infants with BPD, 59 were mild, 103 were moderate and 38 were severe. Eleven patients died during treatment and two died during follow-up. The overall mortality was 6.50% (13 / 200). Multivariate analysis showed that body weight (OR = 0.769, P <0.05) and Apgar score at 1 minute (OR = 0.831, P <0.05) were protective factors for BPD. (OR = 6.397, P <0.05), retinopathy (OR = 3.121, P <0.05) and PDA (OR = 2.973, P <0.05) is a risk factor for BPD in preterm infants. Conclusion The mortality rate of BPD children is high, so it is clinically important to prevent ventilator-associated pneumonia. The incidence of retinopathy and PDA can reduce the incidence of BPD and reduce the mortality of premature infants.