| Objective:To investigate the long-term complications and lung function parameters of premature infants with different severity of bronchopulmonary dysplasia(BPD)by follow-up after discharge and comparing with non-BPD premature infants with similar basic data in the same period,so as to provide guidance for reducing the long-term adverse prognosis and improving the long-term quality of life of children with BPD.Methods:From January 2016 to June 2019 in the neonatal intensive care unit of children’s medical center of Affiliated Hospital of Qingdao University 73 cases of BPD hospitalized in NICU(gestational age < 32 weeks,birth weight < 1500g)and followed up in pediatric clinic after discharge were selected as the observation group,and 45 cases of premature infants in non-BPD group were selected as the control group.According to the criteria of BPD diagnosis and grading in 2018,the premature infants in BPD group were divided into grade I BPD group(n = 41),grade II and III BPD group(n = 32).The cases that did not meet the requirements were excluded.1.Through telephone follow-up,electronic case system to collect the clinical data of the children during hospitalization,and the number of wheezing attacks,lower respiratory tract infection(including bronchitis,pneumonia)times and hospitalization times diagnosed by the outpatient doctors within one year old,and compare the data differences among the groups.2.The three groups of premature infants in the corrected age of 1 month,6 months,12 months,using German KANGXUN pulmonary function instrument for Tidal Pulmonary function examination,record the tidal pulmonary function parameters,compare and evaluate the three groups of children with different corrected age of pulmonary function parameters;at the same time,record their body length,weight,head circumference data in each corrected age,compare the different growth and development of each group.Result:1 General clinical data of three groups1.1 Comparison of general clinical data at birthThe gestational age,birth weight,body length and head circumference of the preterm infants in BPD groups were smaller than those in non-BPD group(P< 0.05);Compared with non-BPD group,1-minute Apgar score was lower,PS application rate was increased,and noninvasive mechanical ventilation time,mask/nasal catheter oxygen inhalation time and total hospital stay were longer in BPD groups(P< 0.05);In addition,the duration of invasive and non-invasive mechanical ventilation and the total length of hospital stay in grade II and III BPD group were significantly longer than those in grade I BPD group and non-BPD group(P< 0.05).1.2 Comparison of body weight,body length and head circumference at the corrective age of 1 monthAt the age of 1 month after correction,the weight and height in grade II and III BPD group were smaller than those in non-BPD group and grade I BPD group(P< 0.05);the head circumference of non-BPD group was larger than those in BPD groups(P< 0.05);the head circumference of grade I BPD group was also significantly larger than those in grade II and III BPD group(P< 0.05).1.3 Comparison of body weight,body length and head circumference at the corrective age of 6 monthAt the age of 6 months after correction,the body length and head circumference in grade II and III BPD group were less than those in grade I BPD group and non-BPD group,the difference was statistically significant(P< 0.05);but there was no significant difference between grade I BPD group and non-BPD group(P > 0.05);The weight of the grade II and III BPD was lower than that of the non-BPD group,the difference was statistically significant(P< 0.05);but there was no significant difference among other groups(P > 0.05).1.4 Comparison of body weight,body length and head circumference at the corrective age of 12 monthAt the age of 12 months of after correction,the weight,length and head circumference of grade II and III BPD group were only lower than those of non-BPD group,and the differences were statistically significant(P< 0.05);There was no significant difference in body weight,length and head circumference among the other groups(P> 0.05).1.5 Comparison of clinical data within 1 year of corrected ageWithin 1 year of corrected age,the frequency of bronchitis in grade II and III BPD group was significantly higher than that in non-BPD group,the difference was statistically significant(P< 0.05);compared with non-BPD group,the frequency of pneumonia,wheezing and rehospitalization in BPD groups were significantly increased,the difference was statistically significant(P< 0.05);the frequency of rehospitalization in grade II and III BPD group was higher than that in grade I BPD group,the difference was statistically significant(P< 0.05).2 Results of tidal pulmonary function2.1 Comparison of Tidal Pulmonary Function Indexes in three groups at the corrective age of 1 monthAt the age of 1 month after correction,the lung function parameters of t PF% t E and VPF% VE in BPD groups were lower than those in non-BPD group,and the difference was statistically significant(P< 0.05);the parameters of TEF25 and TEF50 in grade II and III BPD group were lower than those in non-BPD group,and the RR was higher than that in non-BPD group,and the difference was statistically significant(P< 0.05).2.2 Comparison of Tidal Pulmonary Function Indexes in three groups at the corrective age of 6 monthThe lung function indexes of t PF% t E,VPF% VE,TEF25 and TEF50 in grade II and III BPD group were lower than those in non-BPD group at 6 months after correction,and the RR was higher than that in non-BPD group,the difference was statistically significant(P< 0.05).2.3 Comparison of Tidal Pulmonary Function Indexes in three groups at the corrective age of 12 monthThe lung function indexes of t PF% t E,VPF% VE and TEF25 in grade II and III BPD group were lower than those in non-BPD group at 12 months after correction,and the RR was higher than that in non-BPD group,the difference was statistically significant(P<0.05).Conclusion:1.Gestational age,birth weight,duration of mechanical ventilation,asphyxia and PS application were risk factors for BPD in preterm infants,and invasive mechanical ventilation time,noninvasive mechanical ventilation time,mask / nasal tube oxygen inhalation time and total hospital stay were related to the severity of BPD.2.Premature infants with BPD present with growth retardation before corrected age1 year,and the more severe the degree of BPD,the slower the catch-up growth.3.Within 1 year of corrected age,preterm infants with BPD suffer from an increased number of respiratory problems,the more severe the degree of BPD,the higher the readmission rate.4.There are obstructive changes in tidal lung function within 1 year of corrected age in preterm infants with BPD,and the more severe the degree of BPD,the more pronounced the obstruction. |
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