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[早产儿支气管肺发育不良严重程度的影响因素]

[Influencing factors for severity of bronchopulmonary dysplasia in preterm infants].

作者信息

Li Yan, Wei Qiu-Fen, Pan Xin-Nian, Meng Dan-Hua, Wei Wei, Wu Qiu-Pin

机构信息

Department of Neonatology, Guangxi Women and Children′s Health Hospital, Nanning 530003, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2014 Oct;16(10):1014-8.

Abstract

OBJECTIVE

To explore the influencing factors for the severity of bronchopulmonary dysplasia (BPD) in preterm infants.

METHODS

The clinical data of 110 preterm infants who were diagnosed with BPD and had a hospital stay of over 28 days between January 2011 and December 2013 were analyzed. These BPD infants were divided into 3 groups according to the clinical criteria: mild group (n=52), moderate group (n=44), and severe group (n=14). The relationship between the severity of BPD and the gestational age, birth weight, asphyxia, oxygen therapy, pregnancy complications, intrauterine pneumonia and mechanical ventilation was analyzed.

RESULTS

The severity of BPD was correlated with the following factors: gestational age, birth weight, prenatal infection, duration of oxygen inhalation with a concentration of >40%, use of mechanical ventilation, parameters and duration of mechanical ventilation, duration of continuous positive airway pressure, adoption of intubation surfactant extubation (INSURE) approach, Ureaplasma urealyticum infection, intrauterine pneumonia and patent ductus arteriosus. Logistic regression analysis indicated that the mechanical ventilator parameter peak inspiratory pressure (OR=1.260, 95%CI: 1.096-1.448) and duration of mechanical ventilation (OR=1.010, 95%CI: 1.005-1.016) were independent risk factors for the severity of BPD, while the INSURE approach was a protective factor (OR=0.208, 95%CI: 0.060-0.923).

CONCLUSIONS

The severity of BPD is associated with various factors in preterm infants. The important measures for preventing BPD include avoiding the birth of preterm infants with a very low birth weight, shortening the duration of mechanical ventilation, preventing and reducing pulmonary infections, and applying the INSURE approach.

摘要

目的

探讨早产儿支气管肺发育不良(BPD)严重程度的影响因素。

方法

分析2011年1月至2013年12月期间110例诊断为BPD且住院时间超过28天的早产儿的临床资料。这些BPD患儿根据临床标准分为3组:轻度组(n = 52)、中度组(n = 44)和重度组(n = 14)。分析BPD严重程度与胎龄、出生体重、窒息、氧疗、妊娠并发症、宫内肺炎及机械通气之间的关系。

结果

BPD的严重程度与以下因素相关:胎龄、出生体重、产前感染、吸氧浓度>40%的持续时间、机械通气的使用、机械通气参数及持续时间、持续气道正压通气的持续时间、采用插管-肺表面活性物质-拔管(INSURE)方法、解脲脲原体感染、宫内肺炎及动脉导管未闭。Logistic回归分析表明,机械通气参数吸气峰压(OR = 1.260,95%CI:1.096 - 1.448)和机械通气持续时间(OR = 1.010,95%CI:1.005 - 1.016)是BPD严重程度的独立危险因素,而INSURE方法是保护因素(OR = 0.208,95%CI:0.060 - 0.923)。

结论

BPD的严重程度与早产儿的多种因素有关。预防BPD的重要措施包括避免极低出生体重早产儿出生、缩短机械通气时间、预防和减少肺部感染以及应用INSURE方法。

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