早产儿支气管肺发育不良与解脲支原体临床分析

发布时间：2018-12-21 15:49

【摘要】：目的： 探讨支气管肺发育不良(BPD)的高危因素、临床特点、治疗及解脲支原体感染的临床特点,为BPD的预防和治疗提供借鉴,提高早产儿围生期的生存质量,降低不良预后的发生。 方法： 1.收集本院2007年1月至2011年8月胎龄小于34周的229名早产儿的临床资料,根据有无支气管肺发育不良(BPD)分为2组,对两组的资料进行统计学分析。 2.对2010年9月至2011年8月胎龄小于35周的85名早产儿生后48h内取气道分泌物采用荧光免疫PCR检测法进行UU-DNA测定,并收集其临床资料,根据UU-DNA测定结果分为UU阳性组和UU阴性组,对两组的资料进行统计学分析。 结果： 1.在收治的229例早产儿中男133例(58.1%),女96例(41.9%)。平均胎龄32.30±1.46w,平均体重1760.76±365.78g。 BPD36例(15.7%),其中轻度13例(36.1%),中度21例(58.3%),重度2例(5.6%)。胎龄28周、28周≤胎龄30周、30周≤胎龄32周、32周≤胎龄34周的BPD患儿分别为1例(100%)、12例(63,2%)、10例(20.8%)、13例(8%)。BW1500g、1500g≤BW2000g、2000g≤BW的BPD患儿分别为18例(34.6%)、15例(12.8%)、3例(5%)。229例中共有30例需机械通气治疗,其中发生BPD19例(63.33%)。平均吸氧时间19.0±18天,平均机械通气时间8.3±10.2天,平均住院时间27.7±18.5天,平均出院体重2248.8±390.3g。 2.单因素分析BPD的高危因素有胎龄、出生体重、早产儿合并极低出生体重儿、窒息史、RDS、新生儿肺炎、败血症、呼吸机相关性肺炎、母亲糖尿病、使用PS、静脉使用激素、PH值、抗生素使用时间、吸氧时间、吸氧浓度≥0.4、使用NCPAP、机械通气、白细胞值升高。 3.多因素Logistic回归显示胎龄、IDM、机械通气、吸氧浓度≥0.4,使用NCPAP为BPD的独立危险因素。4.两组在生后14天的体重及头围差异有统计学意义。但在纠正胎龄36周时 体重、身长、头围差异均无统计学意义。 5.两组生后两周摄入的蛋白质量及热卡量差异有统计学意义。 6.UU总体感染率16.5%。 7.UU阳性组BPD发生率21.4%。 8.两组胎膜早破、自然分娩、新生儿肺炎差异有统计学意义。 结论： 1.BPD与胎龄、机械通气、吸氧浓度≥0.4、吸氧等高危因素有关,故积极 避免这些高危因素的发生,可能会降低BPD的发生率。 2.早产儿生后早期供给热卡及蛋白质量不足是BPD发生的高危因素之一。 3.UU可能是引起BPD发生的病原体之一,应引起重视。
[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 卤1.46 wks and the average body weight was 1760.76 卤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，

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