2007 - 2016年早产儿肺出血的治疗与预后
[Treatment and prognosis of pulmonary hemorrhage in preterm infants during 2007-2016].
作者信息
Pan Wei-Wei, Tong Xiao-Mei
机构信息
Department of Pediatrics, Peking University Third Hospital, Beijing 100191, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2018 Apr;20(4):255-260. doi: 10.7499/j.issn.1008-8830.2018.04.001.
OBJECTIVE
To study the treatment and prognosis of pulmonary hemorrhage in preterm infants.
METHODS
A total of 106 preterm infants diagnosed with pulmonary hemorrhage, who were hospitalized in the neonatal ward of Peking University Third Hospital between 2007 and 2016, were enrolled. These patients were divided into 2007-2011 group (34 cases) and 2012-2016 group (72 cases) according to the time of hospitalization, divided into conventional-frequency ventilation group (43 cases) and high-frequency oscillatory ventilation (HFOV) group (63 cases) according to the respiratory support method used after the development of pulmonary hemorrhage, and divided into non-operation group (34 cases) and operation group (14 cases) according to whether PDA ligation was performed for the unclosed PDA before pulmonary hemorrhage. The general data, treatment, and prognosis were compared between different groups.
RESULTS
Compared with the 2007-2011 group, the 2012-2016 group had higher rates of HFOV and PDA ligation (P<0.05), a lower mortality rate during hospitalization (P<0.05), a longer length of hospital stay (P<0.05), and higher incidence rates of intracranial hemorrhage and bronchopulmonary dysplasia (P<0.05). Compared with the conventional-frequency ventilation group, the HFOV group had a lower mortality rate during hospitalization (P<0.05), a longer length of hospital stay (P<0.05), and higher incidence rates of intracranial hemorrhage and bronchopulmonary dysplasia (P<0.05). Compared with the non-operation group, the operation group had a lower mortality rate during hospitalization (P<0.05), a longer length of hospital stay (P<0.05), and higher incidence rates of intracranial hemorrhage and bronchopulmonary dysplasia (P<0.05).
CONCLUSIONS
The application of HFOV and PDA ligation can improve the survival rate of preterm infants with pulmonary hemorrhage, but the incidence of intracranial hemorrhage and bronchopulmonary dysplasia is also increased.
目的
研究早产儿肺出血的治疗及预后情况。
方法
选取2007年至2016年在北京大学第三医院新生儿病房住院的106例诊断为肺出血的早产儿。这些患者根据住院时间分为2007 - 2011组（34例）和2012 - 2016组（72例），根据肺出血发生后所采用的呼吸支持方法分为常频通气组（43例）和高频振荡通气（HFOV）组（63例），根据肺出血前对未闭合的动脉导管未闭（PDA）是否进行结扎分为非手术组（34例）和手术组（14例）。比较不同组之间的一般资料、治疗情况及预后。
结果
与2007 - 2011组相比，2012 - 2016组高频振荡通气及动脉导管未闭结扎率更高（P<0.05），住院期间死亡率更低（P<0.05），住院时间更长（P<0.05），颅内出血及支气管肺发育不良发生率更高（P<0.05）。与常频通气组相比，高频振荡通气组住院期间死亡率更低（P<0.05），住院时间更长（P<0.05），颅内出血及支气管肺发育不良发生率更高（P<0.05）。与非手术组相比，手术组住院期间死亡率更低（P<0.05），住院时间更长（P<0.05），颅内出血及支气管肺发育不良发生率更高（P<0.05）。
结论
高频振荡通气及动脉导管未闭结扎的应用可提高早产儿肺出血的生存率，但颅内出血及支气管肺发育不良的发生率也会增加。
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