Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome

Wu Chen; Deng Chun

doi:10.13406/j.cnki.cyxb.001340

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Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome

更新时间：2024-01-17

- Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome
- Journal of Chongqing Medical University Vol. 42, Issue 8, Pages: 1016-1022(2017)
- 作者机构：
  
  重庆医科大学附属儿童医院新生儿科儿童发育疾病研究教育部重点实验室儿童发育重大疾病国家国际科技合作基地儿科学重庆市重点实验室
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001340
  CLC： R722.1
- Published：2017，
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[1]吴晨,邓春.新生儿呼吸窘迫征并发支气管肺发育不良的高危因素[J].重庆医科大学学报,2017,42(08):1016-1022.

Wu Chen, Deng Chun. Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome. [J]. Journal of Chongqing Medical University 42(8):1016-1022(2017)
[1]吴晨,邓春.新生儿呼吸窘迫征并发支气管肺发育不良的高危因素[J].重庆医科大学学报,2017,42(08):1016-1022. DOI： 10.13406/j.cnki.cyxb.001340.

Wu Chen, Deng Chun. Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome. [J]. Journal of Chongqing Medical University 42(8):1016-1022(2017) DOI： 10.13406/j.cnki.cyxb.001340.

摘要

目的:探讨新生儿呼吸窘迫综合征（neonatal respiratory distress syndrome

NRDS）并发支气管肺发育不良（bronchopulmonary dysplasia

BPD）的高危因素

为BPD的防治提供临床依据

从而降低BPD的发病率。方法:选取2008年1月至2014年12月重庆医科大学新生儿诊治中心收治住院时间大于28 d的NRDS患儿共287例

根据有无并发BPD分为BPD组及非BPD组

对2组的临床资料进行回顾性分析。结果:287例NRDS患儿中131例发生BPD

为BPD组

未发生BPD的患儿共156例

为非BPD组。单因素分析结果显示:胎龄、出生体质量、住院天数、母亲年龄、剖宫产、肺表面活性物质（pulmonary surfactant

PS）使用次数≥2次、PS剂量、痰培养阳性、反复机械通气、呼吸机模式、吸氧浓度FiO2、机械通气时间、总用氧时间、动脉导管未闭（patent ductus arteriosus

PDA）、呼吸机相关性肺炎、肺动脉高压（pulmonary hypertension

PH）患病率、临床治愈、放弃/死亡率、G-杆菌在2组比较中差异有统计学意义（P<0.05）

而BPD组的Apgar1分钟、妊娠期并发症、PS使用率、使用PS的类型、首次PS使用时间、入院前3天血气分析结果、合并新生儿坏死性小肠结肠炎（NEC）、肺气漏、败血症、早产儿视网膜病变（retinopathy of prematurity

ROP）、颅内出血、肺出血等则与非BPD组差异无统计学意义（P>0.05）。多因素logistic回归显示高出生体质量、剖宫产为NRDS并发BPD的独立保护因素

而痰培养阳性率高、反复机械通气、长时间用氧、肺动脉高压为NRDS并发BPD的独立危险因素。结论:及时行剖宫产、避免低出生体重儿、反复上机、长时间氧疗及肺动脉高压为减少BPD发生的最重要措施。

Abstract

Objective:To identify the risk factors for bronchopulmonary dysplasia(BPD)in neonatal respiratory distress syndrome(NRDS). Methods:Data from 287 neonates with RDS who were hospitalized over 28 days were analyzed respectively. Results:Of the287 neonates

131 developed BPD. In univariate analysis

gestational age

birth weight

hospitalization duration

maternal age

cesarean section

the times of pulmonary surfactant(≥2 times)

the dose of pulmonary surfactant

the positive rate of sputum cultures

repeated mechanical ventilation

the mode of mechanical ventilation

the inhaled oxygen volume concentration

the duration of mechanical ventilation

the duration of oxygen

ventilator-associated pneumonia

pulmonary hypertension

patent ductus arteriosus(PDA)

the survival rate and the mortality

gran negative bacillus were all associated with an increase in the incidence of BPD(P<0.05). No significant differences was found in the first minute of Apgar score

the hospitalization time

the fetal distress

gestational complications

the rate of pulmonary surfactant

the time of pulmonary surfactant

the first blood gas analysis scores after birth

combined with neonatal necrotizing enterocolitis(NEC)

air leak

septicemia

retinopathy of prematurity(ROP)

intracranial hemorrhage

pneumorrhagia between the two groups(P>0.05). Multivariate logistic regression model showed that the high birth weight

cesarean section were protecting factors and the the positive rate of sputum cultures

repeated mechanical ventilation

the duration of oxygen and pulmonary hypertension were risk factors for BPD. Conclusion:Shortening the duration of oxygen and preventing the pulmonary hypertension are key methods to reduce BPD in neonates with RDS.

关键词

新生儿呼吸窘迫征支气管肺发育不良新生儿高危因素

Keywords

neonatal respiratory distress syndromebronchopulmonary dysplasianeonatesrisk factors

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