Kramer Boris W, Lievense Sanne, Been Jasper V, Zimmermann Luc J I
Universitair Medisch Centrum, Maastricht, afd. Kindergeneeskunde, School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands.
Ned Tijdschr Geneeskd. 2010;154:A1024.
Chronic lung damage (bronchopulmonary dysplasia (BPD)) is one of the most serious complications affecting preterm neonates. During the last decade the aetiology of BPD has changed. Whereas 'classic BPD' was characterised mainly by lung damage and fibrosis caused by oxygen toxicity and mechanical ventilation, 'new BPD' is characterised by a disorder in lung development. This aetiological shift has been brought about by improved survival in extremely premature infants as a result of, for instance, antenatal corticosteroid administration and postnatal surfactant therapy. New BPD requires a new therapeutic approach. Therapeutic options for developing BPD include caffeine, vitamin A and postnatal corticosteroids. Once BPD has occurred, diuretics and inhaled bronchodilators and corticosteroids may be useful. However, the available therapies decrease the risk of developing BPD by just a small percent. In the future, artificial surfactants and non-invasive ventilation may prove to be useful in the prevention of BPD.
慢性肺损伤（支气管肺发育不良，BPD）是影响早产儿的最严重并发症之一。在过去十年中，BPD的病因已经发生了变化。“经典BPD”主要特征为氧中毒和机械通气导致的肺损伤和纤维化，而“新型BPD”的特征是肺发育紊乱。这种病因学转变是由于例如产前使用皮质类固醇和产后使用表面活性剂治疗，使得极早产儿存活率提高所致。新型BPD需要新的治疗方法。治疗BPD发展的选择包括咖啡因、维生素A和产后皮质类固醇。一旦发生BPD，利尿剂、吸入性支气管扩张剂和皮质类固醇可能会有用。然而，现有的治疗方法仅能将发生BPD的风险降低一小部分。未来，人工表面活性剂和无创通气可能被证明对预防BPD有用。
