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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 2007年1月至2009年12月本院新生儿重症监护病房收住920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 920例早产儿中24例发生BPD,胎龄<28周6例,28～30周13例,～32周3例,～35周2例;出生体重<1000g 6例,1000～1500g 13例,～2500g 5例;轻度BPD 13例,中度BPD 6例,重度BPD 5例;需要机械通气时间为(1.04±26.35)d,需吸氧时间为(47.22±22.49)d,住院时间为(65.29±23.46)d。BPD患儿中合并肺部感染37.5%,脑积水16.7%,早产儿视网膜病16.7%,动脉导管未闭20.8%。所有病例经综合治疗治愈14例,放弃治疗后死亡5例,好转5例,其中3例出院后6个月内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,故积极预防早产,尽量避免机械通气以及减少机械通气、吸氧时间,积极预防和治疗肺部感染及关闭动脉导管可能会减少BPD的发生。
Objective To understand the clinical features of bronchopulmonary dysplasia (BPD) in preterm infants. Methods From January 2007 to December 2009, 920 preterm infants were admitted to our neonatal intensive care unit and their clinical data, such as gestational age, birth weight, primary disease, pulmonary X-ray findings and treatment course, were analyzed. Results Of 920 preterm infants, BPD occurred in 24 cases, gestational age <28 weeks in 6 cases, 28-30 weeks in 13 cases, ~ 32 weeks in 3 cases, ~ 35 weeks in 2 cases; birth weight <1000g in 6 cases, 1000-1500g in 13 cases , ~ 2500g in 5 cases; mild BPD in 13 cases, moderate BPD in 6 cases, severe BPD in 5 cases; required mechanical ventilation was (1.04 ± 26.35) d, oxygen inhalation time was (47.22 ± 22.49) d, hospital stay was (65.29 ± 23.46) d. BPD children with pulmonary infection in 37.5%, hydrocephalus 16.7%, retinopathy of prematurity 16.7%, patent ductus arteriosus 20.8%. All cases were cured by comprehensive treatment in 14 cases, giving up treatment after death in 5 cases, improved in 5 cases, of which 3 were discharged within 6 months after hospitalization due to pulmonary infection. Conclusions Immature pulmonary development in immature infants, prolonged oxygen inhalation and mechanical ventilation, pulmonary infection is the main factor in the occurrence of BPD. Therefore, we should actively prevent premature delivery, avoid mechanical ventilation, reduce mechanical ventilation and oxygen inhalation time, and actively prevent and treat lung Infection and closure of the ductus arteriosus may reduce BPD.