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为了解新生儿支气管肺发育不良症 (BPD)的发病因素、临床特点 ,对17例新生儿BPD的临床资料进行分析。其中男13例 ,女4例 ,胎龄(31.4±3.4)周 ,出生体重(1643±327) g。结果17例BPD原发病中新生儿呼吸窘迫综合征 (NRDS)5例 ,胎粪吸入性肺炎1例 ,肺炎4例 ,呼吸暂停7例。出生后均长时间吸氧、机械通气 ,平均机械通气时间 (26.8±9.7)d。病程第 (16.2±5.6)d ,胸片肺部出现囊状透亮区 ,以后肺呈囊泡样蜂窝样改变。所有病例均并发肺部感染。9例康复出院 ,1例自动出院 ,7例死亡。1例做尸检 ,光镜下两肺广泛纤维化 ,成纤维细胞增生 ,肺泡壁增厚 ,符合BPD诊断。提示早产、长时间吸氧、机械通气、反复肺部感染是BPD的主要发病因素 ,早产儿机械通气超过2周要高度警惕发生BPD。
To understand the pathogenesis and clinical features of neonatal bronchopulmonary dysplasia (BPD), clinical data of 17 neonates with BPD were analyzed. There were 13 males and 4 females, gestational age (31.4 ± 3.4) weeks and birth weight (1643 ± 327) g. Results Among the 17 cases of primary BPD, 5 were neonatal respiratory distress syndrome (NRDS), 1 as meconium aspiration pneumonia, 4 as pneumonia and 7 as apnea. After birth were long oxygen, mechanical ventilation, mean mechanical ventilation (26.8 ± 9.7) d. The course of the disease was (16.2 ± 5.6) d, the cystic translucent area appeared in the chest of the lung, and later the lung was vesicular-like cellular changes. All cases were complicated by pulmonary infection. Nine patients were discharged from hospital, one patient was discharged automatically and seven patients died. One case of autopsy, extensive fibrosis of both lungs under light microscope, fibroblast proliferation, alveolar wall thickening, in line with the diagnosis of BPD. Prompted premature delivery, prolonged oxygen, mechanical ventilation, repeated lung infection is the main risk factor for BPD, premature infants more than 2 weeks mechanical ventilation to be highly alert to the occurrence of BPD.