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支气管肺发育不良的防治——证据及临床应用

Wolfgang THOMAS Christian P SPEER 钱莉玲

中国当代儿科杂志2007,Vol.9Issue(3):264-277,14.
中国当代儿科杂志2007,Vol.9Issue(3):264-277,14.

支气管肺发育不良的防治——证据及临床应用

Prevention and therapy of bronchopulmonary dysplasia - evidence and clinical practice

Wolfgang THOMAS 1Christian P SPEER 1钱莉玲1

作者信息

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摘要

Abstract

The knowledge on the pathogenetic mechanisms of bronchopulmonary dysplasia (BPD) has increased considerably over recent years. However, the incidence of the disease has not substantially been changed by our therapeutic approaches. This review summarizes the existing evidence for a number of respiratory and medical strategies to prevent or ameliorate the disease and gives recommendations for clinical practice. Oxygen plays an important pathogenetic and therapeutic role for BPD. Targeting infants at lower oxygen saturation levels than traditionally used seems to confer major advantages. There is no sufficient evidence for a routine use of respiratory strategies like permissive hypercapnia or inhaled nitric oxide to prevent BPD. Diuretics can ameliorate lung function transiently. High intramuscular doses of vitamin A can reduce the risk of BPD. Early or prophylactic surfactant might also be advantageous. Postnatal corticosteroids are effective but,due to their severe side effects, should be restricted to the severest cases. Alpha1-proteinase inhibitor and superoxide dismutase have no proven benefits for BPD. The role of erythromycin has not been completely elucidated yet. Innovative strategies like Clara Cell 10kD protein still have to be assessed in future trials.

关键词

Bronchopulmonary dysplasia/Evidence-based medicine/Prevention/Amelioration/Preterm infants

Key words

Bronchopulmonary dysplasia/Evidence-based medicine/Prevention/Amelioration/Preterm infants

分类

医药卫生

引用本文复制引用

Wolfgang THOMAS,Christian P SPEER,钱莉玲..支气管肺发育不良的防治——证据及临床应用[J].中国当代儿科杂志,2007,9(3):264-277,14.

中国当代儿科杂志

OACSCDCSTPCDMEDLINE

1008-8830

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