动脉导管未闭, 床旁结扎术, 预后, 极早产儿," /> 动脉导管未闭, 床旁结扎术, 预后, 极早产儿,"/> Extremely preterm infants, Patent ductus arteriosus, Ligation, Bronchopulmonary dysplasia,"/> <span style="line-height:2;font-size:14px;">极早产儿床旁动脉导管结扎围术期状态</span><span style="line-height:2;font-size:14px;">与支气管肺发育不良相关因素分析</span>
Please wait a minute...
欢迎访问发育医学电子杂志,今天是
发育医学电子杂志  2019, Vol. 7 Issue (1): 27-31    DOI: 10.3969/j.issn.2095-5340.2019.01.007
  围产医学   论著 |新生儿 |
极早产儿床旁动脉导管结扎围术期状态与支气管肺发育不良相关因素分析
张艳平 张珊 王自珍 孔祥永 封志纯
解放军总医院第七医学中心八一儿童医院 极早产 NICU,北京 100700
Analysis of related factors on peri-operative status of patent ductus arteriosus ligation and bronchopulmonary dysplasia in extremely preterm infants
ZHANG Yan-ping ZHANG Shan  WANG Zi-zhen  KONG Xiang-yong FENG Zhi-chun
Newborn Care Center, Bayi Children’s Hospital, The Seventh Medical Center, General Hospital of PLA, Beijing 100700 , China)
下载:  PDF (992KB) 
输出:  BibTeX | EndNote (RIS)      
摘要 【摘要】 目的  探讨极早产儿床旁动脉导管未闭(patent ductus arteriosus,PDA)结扎术围术期状态对
支气管肺发育不良(bronchopulmonary dysplasia ,BPD)发生率的影响,并评估在新生儿重症监护病房
(neonatal intensive care unit,NICU)床旁进行手术的安全性。 方法 收集 2015 年 5 月至 2018 年 4 月在解放军总医院第七医学中心附属八一儿童医院极早产 NICU 进行床旁 PDA 结扎术、胎龄在 28 ~ 31+6 周、出生体重在 1 500 g 以下的极早产儿共 44 例,按出院诊断分为 BPD 组(29 例)和无 BPD 组(15 例),对两组患儿胎龄、出生体重、手术时的日龄和体重、布洛芬疗程、RDS 发生率、围术期呼吸机参数和生命体征、机械通气时间、氧疗时间、手术相关并发症和住院时间等临床资料进行分析。采用 t 检验、χ2 检验或 Fisher精确概率法进行统计分析。 结果 BPD 组与无 BPD 组的出生时胎龄[(29.3±2.1)与(30.7±1.6)周]和出生体重[(1 050±190)与(1 220±140)g]比较,BPD 组明显低于无 BPD 组(P值均<0.05),氧疗时间[(36±14)与(27±13)天]和住院时间[(73±22)与(53±19)天]比较,BPD 组均明显长于无 BPD 组(P 值均 <0.05)。而手术时日龄和体重、布洛芬疗程、RDS 发生率以及机械通气时间两组比较差异无统计学意义。BPD 组的术前、术后 24 h 的吸入氧浓度均高于无 BPD 组[0.46±0.13 与 0.33±0.11,0.43±0.12 与 0.32±0.13,P 值均 <0.05]。术前和术后的平均气道压及体温、脉搏和血压两组比较差异均无统计学意义。 结论 极早产儿的未成熟程度(胎龄和出生体重)及与此相关的围术期状态可能是导致 PDA 结扎术后发生BPD 的重要因素;在 NICU 行床旁 PDA 结扎术安全可行。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
张艳平 张珊 王自珍 孔祥永 封志纯
关键词:  动脉导管未闭')" href="#">动脉导管未闭  床旁结扎术  预后  极早产儿    
Abstract: 【Abstract】 Objective    To study the relative factors on peri-operative status of patent ductus arteriosus (PDA) ligation and the bronchopulmonary dysplasia (BPD) in extremely preterm infants and to evaluate the safety of PDA ligation performing in the neonatal intensive care unit (NICU).  Methods From May 2015 to April 2018, 44 cases were admitted with birth weight < 1,500 g and gestational age between 28 to 31+6 weeks and undergoing PDA ligation in the NICU of Bayi Children's Hospital. The infants were divided as BPD group (29 cases) and none BPD group (15 cases) according to their discharge diagnosis. The clinical data were analyzed on gestational age, birth weight, onset date and weight at surgery, ibuprofentherapy, incidence of RDS, perioperative ventilatory parameters and vital signs, duration of ventilation, total days of oxygen therapy, and surgery-related complications and hospital stays of the infants. The statistical analysis was carried out by t test, χ2 test or Fisher exact probability methods. Results The BPD group were lower(all P<0.05 )than the none BPD group in gestational age [(29.3±2.1)vs(30.7±1.6)weeks] and birth weight [(1 050±190) vs (1 220±140) g] significantly.The BPD group were longer (all P<0.05) than the none BPD group in durations of oxygen therapy[(36±14)vs(27±13)d] and the lengths of hospitalization[(73±22)vs(53±19)d] . There were no significant differences in onset date and weight at surgery, time of ibuprofen therapy , incidence of RDS, duration on ventilation. The BPD group were higher (all P<0.05) than the none BPD group in fractions of inspired oxygen before and 24 hours after surgery [0.46±0.13 vs 0.33±0.11, 0.43±0.12 vs 0.32±0.13] .There were no significant differences in mean airway pressure, temperature, pulse and blood pressure on preoperative and postoperative between two groups. Conclusions  The immature degree (gestational age and birth weight) of extremely premature infants and related to the perioperative state may be an important factor to cause occurrencing BPD after PDA ligation . PDA ligation is safe and feasible to perform in the NICU.
Key words:  Extremely preterm infants')" href="#">Extremely preterm infants    Patent ductus arteriosus    Ligation    Bronchopulmonary dysplasia
收稿日期:  2018-11-09                出版日期:  2019-01-30      发布日期:  2019-02-01      期的出版日期:  2019-01-30
基金资助: 国家自然科学基金(81471492)
通讯作者:  孔祥永http://yyk.39.net/doctor/15281.html#practiceExperience    E-mail:  sdkongxy@126.com
引用本文:    
张艳平 张珊 王自珍 孔祥永 封志纯. 极早产儿床旁动脉导管结扎围术期状态与支气管肺发育不良相关因素分析[J]. 发育医学电子杂志, 2019, 7(1): 27-31.
ZHANG Yan-ping ZHANG ShanWANG Zi-zhen KONG Xiang-yong FENG Zhi-chun. Analysis of related factors on peri-operative status of patent ductus arteriosus ligation and bronchopulmonary dysplasia in extremely preterm infants. Journal of Developmental Medicine(Electronic Version), 2019, 7(1): 27-31.
链接本文:  
http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2019.01.007  或          http://www.fyyxzz.com/CN/Y2019/V7/I1/27
[1] 梅亚波 张娜 李秋平 封志纯.
足月新生儿脑梗死 18 例临床资料及预后分析
[J]. 发育医学电子杂志, 2020, 8(4): 346-350.
[2] 骆丽华  刘冬云 杜钦霞  苏林娜  李瑞 李丽丽 王丽华.
物理干预对早产儿喂养质量的临床效果分析
[J]. 发育医学电子杂志, 2020, 8(4): 318-322.
[3] 邓丽君 张翠娟 徐学艳. 宫颈上提缝合术治疗前置胎盘剖宫产术宫颈管出血的效果[J]. 发育医学电子杂志, 2020, 8(2): 178-182.
[4] 孙萌 李育霖 邹卉. 新生儿期异戊酸血症3 例诊治与随访[J]. 发育医学电子杂志, 2020, 8(1): 77-80.
[5] 冯周善 吴繁 贾春宏 孔娟 崔其亮 陈耀勇. 超未成熟儿的临床救治情况[J]. 发育医学电子杂志, 2020, 8(1): 60-66, 91.
[6] 华国伟 于敏 江凯华 郑爱斌 李红新. 窒息新生儿磁共振成像与神经系统预后的相关研究[J]. 发育医学电子杂志, 2018, 6(4): 225-230.
[7] 张继珍. 新生儿高胆红素血症的临床特征及预后[J]. 发育医学电子杂志, 2018, 6(3): 182-185.
[8] 高晓慧, 毛健. 超低出生体重儿非少尿性高钾血症的临床特征[J]. 发育医学电子杂志, 2017, 5(3): 152-158.
[9] 李斌 卿颖杰. 直肠前肿物--卵巢无性细胞瘤1例并文献复习[J]. 发育医学电子杂志, 2016, 4(2): 122-125.
[10] 郭艳杰 郭邑 关怀 等. 胎儿肠管扩张的诊断与预后分析[J]. 发育医学电子杂志, 2016, 4(1): 30-34.
[11] 花少栋 王辉 黄捷婷 赵淑玉 郭婕 周更须 封志纯. 床旁结扎手术治疗16例足月新生儿动脉导管未闭的临床分析[J]. 发育医学电子杂志, 2014, 2(3): 161-165.
[12] 麦瑞芝 房晓祎. 小儿动脉导管未闭的药物治疗进展[J]. 发育医学电子杂志, 2013, 1(4): 230-232.
[1] GAO Xiao-hui, MAO Jian. Clinical features of non-oliguric hyperkalemia in extremely low birth weight infants[J]. Journal of Developmental Medicine(Electronic Version), 0, (): 152 .
[2] Society of Neonatologist, Chinese Medical Doctor Association. Consensus recommendations on the prevention and early management of respiratory distress syndrome in preterm infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 129 -131 .
[3] Professional Committee of Respiratory, Society of Neonatologist, Chinese Medical Doctor Association. Clinical application recommendations for heated humidified high flow nasal cannula[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 132 -135 .
[4] YAN Jun, ZHU Xing-wang, SHI Yuan. Application progress of noninvasive ventilate technique for premature infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 136 -140 .
[5] GU Min-fang, YANG Chuan-zhong. Progress of intrapartum resuscitation for premature infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 141 -145 .
[6] LIU Shu-hua, SHEN Yue-bo, LIU Cui-qing, MA Li. The efficacy of pulmonary surfactant for pulmonary function in premature tension pneumothorax[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 146 -151 .
[7] GAO Xiao-hui, MAO Jian. Clinical features of non-oliguric hyperkalemia in extremely low birth weight infants[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 152 -158 .
[8] XIA Yao-fang, YANG Juan , TIAN Bao-li, et al. Value of amplitude-integrated electroencephalography in monitoring acute period of neonatal bilirubin encephalopathy and prognostic assessment[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 159 -163 .
[9] WANG Li-rong, SUN Xiao-yan, ZHU Ruo-xin, et al. Epidemiological investigation and analysis of women aged 40-55 years old with osteoporosis in Gansu province[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 164 -167 .
[10] CHEN Ru-yue, SHEN Yun-yan, CHEN Qing , et al. Five cases about Henoch-Schönlein purpura complicated with central nervous system injury in children and literatures review[J]. Journal of Developmental Medicine(Electronic Version), 2017, 5(3): 168 -171 .
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed