| Objective: To discuss the clinical characteristics of bronchopulmonary dysplasia, and analyze the clinical difference between mild andmoderate or severe BPD patients in children.Methods: The general informations, prenatal risk factors, primary diseases, complications, blood gas analyses, apgar scorings, pathogenic microorganisms, iconography, treatment and prognosis of BPD diagnosed in pediatrics of children’s hospital affiliated to chongqing medical university from2012.01.01to2012.12.31were analyzed retrospectively. Compare it according to the severity. Among them17cases were mild, and24cases were moderate or severe.Results:(1) General informations: In my study,12cases weremale BPD patients, and20cases were female. Among them,1caseswas triplet pregnancy,10cases were gemellary pregnancy,30caseswere single pregnancy. And its mean gestational age was226.32±31.690days, its average birth weight was1566.13±497.530g, its mean ho spital stays was53.56±28.759days. About the apgar scorings, the mean scores in first1minute was6.39±2.262, first5minutes was7.88±2.157, first10minutes was8.61±1.667. Gestational age, birth weight and the apgar scorings in first1minute were the risk factors for the severity of bronchopulmonary dysplasia.(2) Prenatal factors: In this study, premature rupature of membrane existed in16cases,9caseshad used hormone before birth,1cases had hypertension of pregnancy, no one had gestational diabetes,1cases was placenta previa,1caseshad cholestasis of pregnancy. The difference of prenatal risk factorsbetween mild and moderate or severe BPD patients has no statisticalsignificance.(3) Primary diseases: The most common primary diseases was still NRDS(23cases,56.10%), followed by pneumonia of newborn(17cases,41.43%). The primary diseases of56.25%mild BPD was NRDS, but moderate or severe BPD was higher(58.33%). The difference for distribution of primary diseases between mild and moderate or severe BPD patients has no statistical significance.(4) Complications: Most of the BPD patients had their complications, and amongthem71.17%were respiratory failure,68.29%were intracranial hemorrhage,63.41%were neonatal asphyxia,51.22%were apnea,46.34%were patent ductus arteriosus,19.51%were septicemia,9.76%were retinopathy of prematurity,7.32%were neonatal necrotizing enterocolitis. The difference of Complications between two groups has no statist ical significance.（5）Pathogenic microorganisms: The most commonpathogeny of sputum culture was klebsiella pneumonia pneumonia(60.00%), followed by pseudomonas aeruginosa(32.50%), e.coli(25.00%),baumanii(20.00%) and enterobacter cloacae(7.50%). The cultures of two groups has no statistical difference.(6) Blood gas analyses: Themean blood gas scores was1.85±1.871, and moderate or severe BPDwas higher than mild. But the difference of blood gas scores between two groups has no statistical significance.(7) Iconography: The main imaging findings in the BPD were reticulonodular decrease, bad aeration, heart margin diaphragmatic edge blur, double-lung texture growing blur and disorder, lung field fuzzy and flocculant pieces of shadow. None of them had typical imaging findings of BPD. CT was inspected in27cases, and the mean ages of examination was38.81±13.147days. The main findings of CT were ground-glass opacity, reticulonodular decrease, capsule went up in smoke, pulmonary fibrosis and consolidation shadow. And among them the most common was capsule went up in smoke,6cases were located in upper and lower lobes,11cases were located in lower lobes, and1cases was located inupper lobes. The difference for distribution frequency of capsule went up in smoke between upper and lower lobes has statistical difference(P=0.003).(8) Treatment: All of them accepted anti-infective treatment,31cases(75.61%) accepted mechanical ventilation,26cases(61.41 %) used exogenous PS,24cases(58.54%) used glucocotricoid and27cases(65.85%) used diuretic. The mean ages of the day began to use hormone was39.29±13.598days, and the mean oxygen cure timewas49.53±23.748days. Besides, all of them acquired energy intestinal nutrition anside and outside. The total energy of first3days was158.13±42.788kcal/kg. first7days was466.53±112.422kcal/kg, and first10days was740.47±161.049kcal/kg. The total fluid content of first3days was448.53±140.410ml, first7days1211.40±347.865ml, first10days was1831.97±561.37ml。The mean dosage of vitamin A was1512.20±661.323IU/d. The difference of whether mechanical ventilation or not, duration ventilator support and oxygen cure time betweenthe two groups has statistical difference.(9) Prognosis: In41cases,35cases were better or healing after anti-infective trentment and mechanical ventilation,6cases were died(14.63%). The mortality of mildand moderate group was higher than mild group, and the differencebetween them has statistical significance. About the condition of post-discharge,12cases were not hospitalized at all,8cases were in hospital within3months because of respiratory diseases, and15cases were out of touch.Conclusion: Small gestational age, low birth weight, apgar scorings in first1minute, whether mechanical ventilation or not, durationventilator support and oxygen cure time were the risk factors for in fluence the scale division of bronchopulmonary dysplasia. The mortality of two groups has statistical difference. |
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