新型支气管肺发育不良
The new bronchopulmonary dysplasia.
机构信息
Cincinnati Children's Hospital, Division of Pulmonary Biology, University of Cincinnati, Cincinnati, Ohio 45229-3039, USA.
出版信息
Curr Opin Pediatr. 2011 Apr;23(2):167-72. doi: 10.1097/MOP.0b013e3283423e6b.
PURPOSE OF REVIEW
Bronchopulmonary dysplasia (BPD) remains the most common severe complication of preterm birth. A number of recent animal models and clinical studies provide new information about pathophysiology and treatment.
RECENT FINDINGS
The epidemiology of BPD continues to demonstrate that birth weight and gestational age are most predictive of BPD. Correlations of BPD with chorioamnionitis are clouded by the complexity of the fetal exposures to inflammation. Excessive oxygen use in preterm infants can increase the risk of BPD but low saturation targets may increase death. Numerous recent trials demonstrate that many preterm infants can be initially stabilized after delivery with continuous positive airway response (CPAP) and then be selectively treated with surfactant for respiratory distress syndrome. The growth of the lungs of the infant with BPD through childhood remains poorly characterized.
SUMMARY
Recent experiences in neonatology suggest that combining less invasive care strategies that avoid excessive oxygen and ventilation, decrease postnatal infections, and optimize nutrition may decrease the incidence and severity of BPD.
目的综述
支气管肺发育不良（BPD）仍然是早产儿最常见的严重并发症。一些最近的动物模型和临床研究为其病理生理学和治疗提供了新的信息。
最近的发现
BPD 的流行病学继续表明，出生体重和胎龄是预测 BPD 的最主要因素。BPD 与绒毛膜羊膜炎的相关性因胎儿暴露于炎症的复杂性而变得复杂。早产儿过度吸氧会增加 BPD 的风险，但低饱和度目标可能会增加死亡率。最近的许多试验表明，许多早产儿在分娩后可以通过持续气道正压通气（CPAP）初步稳定，然后有选择地使用表面活性剂治疗呼吸窘迫综合征。患有 BPD 的婴儿的肺部在儿童期的生长情况仍描述不佳。
总结
新生儿科的最新经验表明，结合避免过度吸氧和通气、减少产后感染和优化营养的微创护理策略，可能会降低 BPD 的发生率和严重程度。
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