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[新生儿呼吸窘迫综合征患儿支气管肺发育不良的危险因素]

[Risk factors for bronchopulmonary dysplasia in neonates with respiratory distress syndrome].

作者信息

Chen You, Han Yu-Kun, Ye Zhen-Zhi, Lu Guang-Jin

机构信息

Department of Neonatology, Baoan Maternal and Child Health Hospital, Shenzhen, Guangdong, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2007 Feb;9(1):15-8.

Abstract

OBJECTIVE

To identify the risk factors for bronchopulmonary dysplasia (BPD) in neonates with respiratory distress syndrome (RDS).

METHODS

Data from 72 patients with RDS (birth weight 1607 +/- 277 g; gestational age 29.47 +/- 2.54 weeks) who were hospitalized for >28 days and who received mechanical ventilation treatment between January 2001 and August 2005 were studied retrospectively. A logistic regression analysis was used to identify the risk factors associated with the development of BPD.

RESULTS

Of the 72 patients, 17 developed BPD (23.6%). Uniovariate analysis revealed that in addition to a gestational age of < or = 30 weeks and a birth weight below 1250 g, the times of mechanical ventilation treatment (> or = 2 times), concurrent pulmonary infection and pneumorrhagia, prolonged mechanical ventilation (> or = 5 days), and positive sputum bacterial cultures on 2 occasions were all associated with an increase in the incidence of BPD. Multivariate logistic analysis revealed that birth weight below 1250 g, prolonged mechanical ventilation (> or = 10 days),and positive sputum cultures on 3 or more occasions were independent risk factors for BPD (OR=6.614,14.997 and 39.752 respectively).

CONCLUSIONS

The risk for BPD is multifactorial. Preventing small gestational age and low birth weight prematurity, decreasing the duration of mechanical ventilation and treatment of pulmonary infection are necessary to prevent BPD.

摘要

目的

确定呼吸窘迫综合征(RDS)新生儿发生支气管肺发育不良(BPD)的危险因素。

方法

回顾性研究2001年1月至2005年8月期间住院时间超过28天且接受机械通气治疗的72例RDS患儿(出生体重1607±277g;胎龄29.47±2.54周)的数据。采用逻辑回归分析确定与BPD发生相关的危险因素。

结果

72例患儿中,17例发生BPD(23.6%)。单因素分析显示,除胎龄≤30周和出生体重低于1250g外,机械通气治疗次数(≥2次)、并发肺部感染和肺出血、机械通气时间延长(≥5天)以及痰细菌培养2次阳性均与BPD发病率增加有关。多因素逻辑分析显示,出生体重低于1250g、机械通气时间延长(≥10天)以及痰培养3次或更多次阳性是BPD的独立危险因素(OR分别为6.614、14.997和39.752)。

结论

BPD的发生风险是多因素的。预防小胎龄和低出生体重早产、缩短机械通气时间以及治疗肺部感染对于预防BPD是必要的。

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