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目的探讨早产儿支气管肺发育不良(BPD)的危险因素及预防对策。方法回顾性分析本院2000年1月至2005年8月应用呼吸机治疗并住院28 d以上的早产儿,比较并综合分析20余种高危因素与BPD发生的关系。结果106例呼吸机治疗、住院>28 d早产儿BPD发生率为30.19%(32/106),占所有住院28 d以上早产儿的13.91%(32/230),占住院28 d以上、应用机械通气治疗、出生体重≤1 500 g早产儿的18.52%(25/135)。BPD组FiO2、PIP、PEEP、MAP、上机时日龄与对照组无显著性差异(P>0.05)。多因素Logistic回归分析显示:出生体重≤1 250 g、机械通气≥10 d、痰培养阳性2次以上为发生BPD的独立危险因素。结论避免低出生体重早产儿、缩短应用机械通气时间、防止及减少肺部感染,尤其是严重感染是预防早产儿发生BPD的重要措施。
Objective To explore the risk factors and preventive strategies of bronchopulmonary dysplasia (BPD) in preterm infants. Methods A retrospective analysis of our hospital from January 2000 to August 2005 ventilator treatment and hospitalized more than 28 days of premature children, compared and comprehensive analysis of more than 20 kinds of risk factors and the occurrence of BPD. Results The incidence of BPD in 106 cases of ventilator treatment and hospitalization> 28 days was 30.19% (32/106), accounting for 13.91% (32/230) of all 28 days of premature infants hospitalized, accounting for more than 28 days of hospitalization. Ventilation, 18.52% (25/135) of preterm infants with birth weight ≤1,500 g. There was no significant difference in FiO2, PIP, PEEP, MAP, BPD group day-old when compared with the control group (P> 0.05). Multivariate Logistic regression analysis showed that birth weight ≤1 250 g, mechanical ventilation ≥10 d, and sputum culture positive more than twice were independent risk factors of BPD. Conclusions Avoiding low birth weight premature infants, shortening the time of mechanical ventilation and preventing and reducing pulmonary infection, especially serious infection, are important measures to prevent BPD in preterm infants.