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目的:探讨影响不同分度早产儿支气管肺发育不良(BPD)的临床高危因素,为临床防治提供参考。方法:选取重庆医科大学附属儿童医院2013-2014年收治的BPD早产儿81例,按照临床分度标准分为轻度组24例和中重度组57例,对其围产期情况、母孕期情况、合并症、临床治疗及预后情况进行回顾性分析。结果:中重度组呼吸窘迫综合征(RDS)、呼吸衰竭、动脉导管未闭(PDA)、先天性心脏病、肺出血、消化道出血的患儿比例高于轻度组,机械通气时间长于轻度组,日增长体质量低于轻度组(P均<0.05)。两组在性别、胎龄、胎数、出生体质量、母亲年龄、产前激素及出生后肺表面活性剂的应用等方面比较差异均无统计学意义(P均>0.05)。结论:积极防治RDS、肺出血、消化道出血、PDA等合并症是减少早产儿BPD的关键,尽可能缩短机械通气时间是重要措施之一。
Objective: To explore the clinical risk factors of bronchopulmonary dysplasia (BPD) in preterm infants with different index, and to provide reference for clinical prevention and treatment. Methods: A total of 81 preterm infants with BPD admitted to Children’s Hospital of Chongqing Medical University from 2013 to 2014 were divided into mild group (n = 24) and moderate and severe group (n = 57) according to the clinical criteria. Their perinatal status, , Complications, clinical treatment and prognosis were retrospectively analyzed. Results: The proportion of children with respiratory distress syndrome (RDS), respiratory failure, patent ductus arteriosus (PDA), congenital heart disease, pulmonary hemorrhage and gastrointestinal bleeding in moderate and severe group was higher than that in mild group. The duration of mechanical ventilation was longer than that of mild Degree group, daily body weight was lower than the mild group (P <0.05). There was no significant difference in gender, gestational age, birth weight, birth weight, mother’s age, prenatal hormones and postnatal pulmonary surfactant application (P> 0.05). Conclusion: The prevention and treatment of RDS, pulmonary hemorrhage, gastrointestinal bleeding, PDA and other complications is the key to reduce BPD in preterm infants. It is one of the important measures to shorten the duration of mechanical ventilation.