Kim Jin Kyu, Chang Yun Sil, Sung Sein, Ahn So Yoon, Yoo Hye Soo, Park Won Soon
Department of Pediatrics, Chonbuk National University School of Medicine, Jeonju, Korea.; Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.
Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea .
J Korean Med Sci. 2016 Mar;31(3):423-9. doi: 10.3346/jkms.2016.31.3.423. Epub 2016 Feb 17.
The aim of this study was to investigate the relationship between survival and incidence of bronchopulmonary dysplasia (BPD) in extremely premature infants, and identify clinical factors responsible for this association. Medical records of 350 infants at 23-26 weeks gestation from 2000 to 2005 (period I, n = 137) and 2006 to 2010 (period II, n = 213) were retrospectively reviewed. The infants were stratified into 23-24 and 25-26 weeks gestation, and the survival, BPD incidence, and clinical characteristics were analyzed. BPD was defined as oxygen dependency at 36 weeks postmenstrual age. The overall survival rate was significantly improved in period II compared to period I (80.3% vs. 70.0%, respectively; P = 0.028), especially in infants at 23-24 weeks gestation (73.9% vs. 47.4%, respectively; P = 0.001). The BPD incidence in survivors during period II (55.0%) was significantly decreased compared to period I (67.7%; P = 0.042), especially at 25-26 weeks gestation (41.7% vs. 62.3%, respectively; P = 0.008). Significantly improved survival at 23-24 weeks gestation was associated with a higher antenatal steroid use and an improved 5-minute Apgar score. A significant decrease in BPD incidence at 25-26 weeks gestation was associated with early extubation, prolonged use of less invasive continuous positive airway pressure, and reduced supplemental oxygen. Improved perinatal and neonatal care can simultaneously lead to improved survival and decreased BPD incidence in extremely premature infants.
本研究旨在调查极早产儿的生存率与支气管肺发育不良（BPD）发生率之间的关系，并确定导致这种关联的临床因素。回顾性分析了2000年至2005年（第一阶段，n = 137）和2006年至2010年（第二阶段，n = 213）期间350例孕23 - 26周婴儿的病历。将婴儿按孕23 - 24周和25 - 26周进行分层，并分析其生存率、BPD发生率及临床特征。BPD定义为孕龄36周时需氧依赖。与第一阶段相比，第二阶段的总体生存率显著提高（分别为80.3%和70.0%；P = 0.028），尤其是孕23 - 24周的婴儿（分别为73.9%和47.4%；P = 0.001）。第二阶段存活者的BPD发生率（55.
