早产儿支气管肺发育不良危险因素探讨.docVIP

早产儿支气管肺发育不良危险因素探讨 　　[摘要] 目的：调查早产儿支气管肺发育不良（BPD）发病的危险因素，为其防治提供理论依据。方法：回顾性分析2006年1月～2010年12月在我院及昆明市儿童医院新生儿病房住院的早产儿430例，分析胎龄、出生体重等17种可能的相关因素与BPD的关系。结果：430例早产儿中，45例发生BPD，发病率为10.47%。单因素分析显示，母亲有胎膜早破、产道感染、产前应用糖皮质激素、患儿为试管婴儿、男婴、胎龄 　　[关键词] 支气管肺发育不良；危险因素；早产儿 　　[中图分类号] R722.6 [文献标识码]Ａ [文章编号]1673-7210（2011）04（a）-052-03 　　 　　Clinical study on risk factors for bronchopulmonary dysplasia in premature infants 　　LI Yuanbin1, WANG Aiping 2, LI Weidong1 　　1.Department of Pediatrics, the Affiliated Xiaolan Hospital of Southern Medical University, Zhongshan 528415, China; 2.Neonatal Department, the Children′s Hospital of Kunming City, Kunming 650100, China 　　[Abstract] Objective: To investigate the risk factors for bronchopulmonary dysplasia (BPD) in premature infants and provide a basis for its prevention and treatment. Methods: 430 premature infants admitted to neonatal intensive care units (NICU) of Children′s Hospital of Kunming City and our hospital from January 2006 to December 2010 were investigated by a retrospective study. The relationship between 17 associated factors including gestational age (GA), birth weight (BW) and BPD were analyzed. Results: Among 430 cases of premature infants, there were 45 BPD cases with the incidence of 10.47%. The potential risk factors of BPD in univariate pearson′s Chi-Square test were premature rupture of membranes, genital tract infection， prenatal application of glucocorticoids, test-tube baby, male, GA 　　1.3 统计学处理 　　采用SPSS 10.0统计软件，单因素分析采用χ2检验，多因素分析采用Backward（Likelihood Ratio）Logistic回归分析，P0.05）（表2、3）。 　　2.2 BPD危险因素的多因素分析 　　选择单因素分析中有统计学意义的发病因素15个：母亲有胎膜早破、产道感染、产前应用糖皮质激素（GC）、患儿为试管婴儿、男婴、GA＜32周、BW＜1 500 g、出生时血pH＜7.20、患有RDS、感染性肺炎、呼吸暂停、PDA、败血症、应用机械通气和PS治疗，以它们作为自变量，以BPD??应变量，作Backward Logistic回归分析，发现GA＜32周、BW＜1 500 g、感染性肺炎、PDA开放和机械通气等为BPD发病的独立危险因素（表4）。 　　 　　表4 430例早产儿BPD发病危险因素Logistic回归分析 　　 　　3 讨论 　　支气管肺发育不良（BPD）是一种与早产相关的慢性肺部疾病，临床上分为经典型BPD和新型BPD两种。前者以肺泡和气道结构严重破坏、 肺严重纤维化为特征，见于需要机械通气的相对较成熟的早产儿，有典型的X线表现[4]；而后者以肺发育受阻为特征，表现为肺