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智利早产慢性肺病婴儿的管理

Management of infants with chronic lung disease of prematurity in Chile.

作者信息

Palomino Maria Angélica, Morgues Mónica, Martínez Fernando

机构信息

Departamento de Pediatría Norte, Facultad de Medicina, Universidad de Chile, Respiratory Unit, Roberto del Río Children's Hospital, Zañartu 1085, Independencia, Santiago, Chile.

出版信息

Early Hum Dev. 2005 Feb;81(2):143-9. doi: 10.1016/j.earlhumdev.2004.12.003. Epub 2005 Jan 26.

Abstract

Despite advances in the prevention and management of respiratory distress syndrome, chronic lung disease of prematurity (CLD) remains a major cause of morbidity and mortality in preterm babies in Chile. Its incidence varies from 10% to 60% in different regions of Chile. Since 1998, the management of CLD after discharge from neonatal unit follows national guidelines. Target oxygen saturation is 85% to 91% in the first 1 week of life, 91% to 94% from 1 to 2 weeks and over 95% after 44 weeks postconceptional age. National home oxygen program has improved outcome in infants with CLD. Other specific treatments are used with caution. Diuretics are used for pulmonary oedema. The adverse neurological outcome in infants treated with postnatal steroids restricts its use to infants who cannot be weaned from mechanical ventilation. Inhaled steroids and bronchodilators may reduce asthma-like symptoms in established CLD. Prevention of RSV infection in CLD babies is paramount. The preterm infant population has been maintained under surveillance nationally since 1998.

摘要

尽管在呼吸窘迫综合征的预防和管理方面取得了进展,但慢性肺疾病(CLD)仍是智利早产儿发病和死亡的主要原因。其发病率在智利不同地区从10%到60%不等。自1998年以来,新生儿病房出院后CLD的管理遵循国家指南。出生后第1周的目标氧饱和度为85%至91%,1至2周为91%至94%,孕龄44周后超过95%。国家家庭氧疗计划改善了CLD婴儿的预后。其他特定治疗需谨慎使用。利尿剂用于治疗肺水肿。产后使用类固醇治疗的婴儿出现不良神经结局,限制了其仅用于无法撤机的婴儿。吸入性类固醇和支气管扩张剂可能减轻已确诊CLD婴儿的哮喘样症状。预防CLD婴儿感染呼吸道合胞病毒(RSV)至关重要。自1998年以来,全国范围内对早产儿群体进行了监测。

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