發(fā)布時(shí)間：2018-12-21 15:49

【摘要】：目的： 探討支氣管肺發(fā)育不良(BPD)的高危因素、臨床特點(diǎn)、治療及解脲支原體感染的臨床特點(diǎn),為BPD的預(yù)防和治療提供借鑒,提高早產(chǎn)兒圍生期的生存質(zhì)量,降低不良預(yù)后的發(fā)生。 方法： 1.收集本院2007年1月至2011年8月胎齡小于34周的229名早產(chǎn)兒的臨床資料,根據(jù)有無(wú)支氣管肺發(fā)育不良(BPD)分為2組,對(duì)兩組的資料進(jìn)行統(tǒng)計(jì)學(xué)分析。 2.對(duì)2010年9月至2011年8月胎齡小于35周的85名早產(chǎn)兒生后48h內(nèi)取氣道分泌物采用熒光免疫PCR檢測(cè)法進(jìn)行UU-DNA測(cè)定,并收集其臨床資料,根據(jù)UU-DNA測(cè)定結(jié)果分為UU陽(yáng)性組和UU陰性組,對(duì)兩組的資料進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 1.在收治的229例早產(chǎn)兒中男133例(58.1%),女96例(41.9%)。平均胎齡32.30±1.46w,平均體重1760.76±365.78g。 BPD36例(15.7%),其中輕度13例(36.1%),中度21例(58.3%),重度2例(5.6%)。胎齡28周、28周≤胎齡30周、30周≤胎齡32周、32周≤胎齡34周的BPD患兒分別為1例(100%)、12例(63,2%)、10例(20.8%)、13例(8%)。BW1500g、1500g≤BW2000g、2000g≤BW的BPD患兒分別為18例(34.6%)、15例(12.8%)、3例(5%)。229例中共有30例需機(jī)械通氣治療,其中發(fā)生BPD19例(63.33%)。平均吸氧時(shí)間19.0±18天,平均機(jī)械通氣時(shí)間8.3±10.2天,平均住院時(shí)間27.7±18.5天,平均出院體重2248.8±390.3g。 2.單因素分析BPD的高危因素有胎齡、出生體重、早產(chǎn)兒合并極低出生體重兒、窒息史、RDS、新生兒肺炎、敗血癥、呼吸機(jī)相關(guān)性肺炎、母親糖尿病、使用PS、靜脈使用激素、PH值、抗生素使用時(shí)間、吸氧時(shí)間、吸氧濃度≥0.4、使用NCPAP、機(jī)械通氣、白細(xì)胞值升高。 3.多因素Logistic回歸顯示胎齡、IDM、機(jī)械通氣、吸氧濃度≥0.4,使用NCPAP為BPD的獨(dú)立危險(xiǎn)因素。4.兩組在生后14天的體重及頭圍差異有統(tǒng)計(jì)學(xué)意義。但在糾正胎齡36周時(shí) 體重、身長(zhǎng)、頭圍差異均無(wú)統(tǒng)計(jì)學(xué)意義。 5.兩組生后兩周攝入的蛋白質(zhì)量及熱卡量差異有統(tǒng)計(jì)學(xué)意義。 6.UU總體感染率16.5%。 7.UU陽(yáng)性組BPD發(fā)生率21.4%。 8.兩組胎膜早破、自然分娩、新生兒肺炎差異有統(tǒng)計(jì)學(xué)意義。 結(jié)論： 1.BPD與胎齡、機(jī)械通氣、吸氧濃度≥0.4、吸氧等高危因素有關(guān),故積極 避免這些高危因素的發(fā)生,可能會(huì)降低BPD的發(fā)生率。 2.早產(chǎn)兒生后早期供給熱卡及蛋白質(zhì)量不足是BPD發(fā)生的高危因素之一。 3.UU可能是引起B(yǎng)PD發(fā)生的病原體之一,應(yīng)引起重視。
[Abstract]:Objective: to investigate the high risk factors, clinical characteristics and clinical characteristics of bronchopulmonary dysplasia (BPD), to provide reference for the prevention and treatment of BPD, and to improve the perinatal quality of life of premature infants. To reduce the incidence of poor prognosis. Methods: 1. The clinical data of 229 premature infants whose gestational age was less than 34 weeks from January 2007 to August 2011 were collected and divided into two groups according to the presence or absence of bronchopulmonary dysplasia (BPD). The data of the two groups were analyzed statistically. 2. The airway secretions from 85 premature infants whose gestational age was less than 35 weeks from September 2010 to August 2011 were measured by fluorescence immunoassay (PCR) within 48 hours after birth, and their clinical data were collected. According to the results of UU-DNA, the data of UU positive group and UU negative group were analyzed statistically. Results: 1. Among 229 premature infants, 133 were male (58.1%) and 96 were female (41.9%). The mean gestational age was 32.30 鹵1.46 wks and the average body weight was 1760.76 鹵365.78 g. BPD36 was found in 13 cases (36.1%), moderate in 21 cases (58.3%) and severe in 2 cases (5.6%). At 28 weeks, 28 weeks 鈮，

本文編號(hào)：2389120