ABSTRACT
Objective@#To investigate the clinical features and pulmonary function of preterm infant-bronchopulmonary dysplasia-wheezing syndrome(PBPDWS).@*Methods@#Twenty-five cases of children with PBPDWS who were hospitalized at Anhui Provincial Hospital Affiliated to Anhui Medical University were collected, and 24 cases of non-bronchopulmonary dysplasia (BPD) preterm infants and 26 cases of term infants with the same symptoms of wheezing were selected as the control group.A retrospective analysis was performed among 3 groups of children.The perinatal conditions, the days of wheezing within 1 year after birth, the number of lower respiratory tract infection, the days of hospitalization, and 1 year after the birth of the pulmonary function result of these children were compared; due to recurrent respiratory symptoms, pulmonary CT was performed on children with BPD when they were 6 to 12 months after birth, their pulmonary CT of these children were analyzed, and the pulmonary CT was compared at birth.@*Results@#There were significant differences in body height and weight between the 3 groups (P<0.05), among which PBPDWS group was the lowest, and the term infants group was the highest [(70.40±3.48) cm, (74.50±1.87) cm, (77.92±3.01) cm, P=0.000; (7.97±1.04) kg, (9.51±1.15) kg, (10.38±1.47) kg, P=0.000]. There was significant difference in the number of wheezing (F=71.389, P<0.05), among which the PBPDWS group was the highest and the term infants group was the lowest [(7.4±1.8) times, (4.2±1.2) times, (3.4±0.6) times]; during the first year of life, PBPDWS group had 18 cases of respiratory tract infection, 9 cases in non-BPD preterm infants group, 3 cases in term infants group, the difference among the 3 groups was statistically significant(χ2=19.505, P<0.05); 16 cases in PBPDWS group were hospitalized within 1 year after birth, 7 cases in non-BPD preterm infants group, 2 cases in term infants group, the difference among the 3 groups was statistically significant(χ2=18.460, P<0.05). There were significant differences in the indexes of pulmonary function[ time to peak tidal expiratory flow as a proportion of expiratory time(tPF%tE) and volume to peak expiratory flow as a proportion of exhaled volume(VPF%VE)] among the 3 groups(all P<0.05), among which PBPDWS group was the lowest and the term group was the highest [(15.69±4.29)%, (20.63±1.90)%, (25.95±3.79)%; (19.13±3.16)%, (21.51±2.17)%, (28.02±4.84)%]; the main manifestations of lung CT in PBPDWS group at 6 to 12 mouths, included 9 cases had limited emphysema(36%), 20 cases with fiber strips, grid shadow and triangular subpleural opacities(80%), 6 cases had bronchiectasis(24%), the same child with non-single lesion, often 2 to 3 lesions coexist.@*Conclusion@#PBPDWS children have high prevalence rate of respiratory diseases, growth retardation, pulmonary function has a certain obstruction, pulmonary CT has a specific imaging characteristics.
ABSTRACT
Objective To study the clinical effects of extensively hydrolyzed protein formula (eHPF) and standard preterm infant formula (SPF) in very/extremely low weight (V/ELBW) infants.To provide a theoretical basis for the early feeding of V/ELBW infants.Method From August 2015 to August 2016, V/ELBW infants (gestational age <32 w and birth weight <1500 g) hospitalized in our neonatal ward were randomly assigned into eHPF group and SPF group .The eHPF group received eHPF feeding from birth to corrected gestational age of 32 weeks, and then fed with SPF;the SPF group was fed with SPF after birth.The clinical data of the two groups were compared including the time needed to regain birth weight , the time needed to achieve total enteral nutrition , the duration of nasogastric tube usage , the complications and blood biochemical indexes .Result A total of 85 cases were included in the eHPF group , and 91 cases in the SPF group.The hospitalization duration , weight increase rate , nasogastric tube duration , the time needed to regain birth weight , the time needed to achieve total enteral nutrition of eHPF group were better than SPF group [ ( 38.4 ±7.8 ) d vs.( 42.1 ±11.0 ) d, ( 25.5 ±10.1 ) g/d vs.( 21.8 ±7.8 ) g/d, (12.1 ±4.0) d vs.(16.0 ±3.8) d, (11.6 ±3.9) d vs.(13.0 ±3.8) d, (9.3 ±2.2) d vs.(14.3 ±1.8) d], and the differences were statistically significant (P<0.05).No statistically differences existed on discharge weight between the two groups ( P>0.05 ) .Compared with the SPF group , the incidences of cholestasis, NEC and feeding intolerance were lower in the eHPF group (22.7% vs.24.3%, 6.8% vs. 7.2%, 15.9%vs.17.1%) , and the differences were statistically significant ( P<0.05 ) .No significant differences existed on the incidence of extrauterine growth retardation between the two groups (P>0.05). No significant differences existed on serum total bilirubin level at 7 d after birth between the two groups ( P>0.05).Compared with the SPF group , the serum total bilirubin at 14 d was lower in the eHPF group [(40.3 ±23.0)μmol/L vs.(53.6 ±26.5) μmol/L], the serum total protein [(50.5 ±3.7) g/L vs. (46.7 ±5.3) g/L] and albumin[(31.3 ±4.1) g/L vs.(29.4 ±5.2) g/L] at 21 d were higher, the differences were statistically significant ( P<0.05 ) .Conclusion eHPF can shorten the time needed to achieve total enteral nutrition and regain birth weight , accelerate the regression of hyperbilirubinemia , reduce the incidences of feeding intolerance and NEC , and it is a safe and effective choice for enteral nutrition in V/ELBW infants.
ABSTRACT
Objective:To study the clinical characteristics,prognosis and drug resistance caused by the non fermenting bacteria in the infants,and to provide reference for the doctors to recognize the infection features and its treatment.Methods:A total of 91 cases of non-fermentative bacteria infection were selected and the clinical materials were retrospectively analyzed.The clinical data and prognosis of the pediatric patients were analyzed,as well as the distribution and drug resistance of non-fermentative bacteria.The bacterial resistance genes were detected by PCR method,and the positive results were analyzed by gene sequencing.Results:In the past 5 years,the nonfermentative bacteria strains were isolated in 91 infant patients,including 35 cases of newborn (19 cases were premature infants),29 cases aged less than 1 year old,27 cases aged from 0 year to 3 years old.Among these patients,60 were male and 31 were female.There were 41 cases with underlying diseases (45.05 ％),16 cases with organ dysfunction (17.58％),3 cases discharged automatically (3.29 ％),and 1 case dead (1.09 ％).A total of 102 strains of non-fermentative bacteria included 42 strains of Pseudomonas aeruginosa,33 strains of Acinetobacter baumannii,21 strains of Stenotrophomonas maltophilia and 6 strains of other non-fermentative bacteria.Forty-four strains were isolated from neonatal ward,33 strains (32.35％) from neonatal ICU (43.13 ％),25 strains (24.50％) were isolated from general pediatric ward.These strains were mainly from respiratory tract secretions and blood samples,nearly 84.31％.The isolation rates of MDR,XDR,PDR Acinetobacter baumannii and Pseudomonas aeruginosa were 63.63％ and 19.04％,respectively.There were 40.48％ of Pseudomonas aeruginosa isolates were resistant to imipenem,blaPER had the highest positive gene rate (28.57％).There were 36.36％ of Acinetobacter baumannii isolates were resistant to imipenem,all resistant strains carried blaOXA-51 and blaOXA-23 genes.Conclusion:The infants with underlying diseases or invasive diagnosis and treatment are easy to infect non fermentative bacteria.Most strains of them are drug-resistant and difficult to be treated with long duration and high risk.
ABSTRACT
Objective:To study the clinical characteristics,prognosis and drug resistance caused by the non fermenting bacteria in the infants,and to provide reference for the doctors to recognize the infection features and its treatment.Methods:A total of 91 cases of non-fermentative bacteria infection were selected and the clinical materials were retrospectively analyzed.The clinical data and prognosis of the pediatric patients were analyzed,as well as the distribution and drug resistance of non-fermentative bacteria.The bacterial resistance genes were detected by PCR method,and the positive results were analyzed by gene sequencing.Results:In the past 5 years,the nonfermentative bacteria strains were isolated in 91 infant patients,including 35 cases of newborn (19 cases were premature infants),29 cases aged less than 1 year old,27 cases aged from 0 year to 3 years old.Among these patients,60 were male and 31 were female.There were 41 cases with underlying diseases (45.05 ％),16 cases with organ dysfunction (17.58％),3 cases discharged automatically (3.29 ％),and 1 case dead (1.09 ％).A total of 102 strains of non-fermentative bacteria included 42 strains of Pseudomonas aeruginosa,33 strains of Acinetobacter baumannii,21 strains of Stenotrophomonas maltophilia and 6 strains of other non-fermentative bacteria.Forty-four strains were isolated from neonatal ward,33 strains (32.35％) from neonatal ICU (43.13 ％),25 strains (24.50％) were isolated from general pediatric ward.These strains were mainly from respiratory tract secretions and blood samples,nearly 84.31％.The isolation rates of MDR,XDR,PDR Acinetobacter baumannii and Pseudomonas aeruginosa were 63.63％ and 19.04％,respectively.There were 40.48％ of Pseudomonas aeruginosa isolates were resistant to imipenem,blaPER had the highest positive gene rate (28.57％).There were 36.36％ of Acinetobacter baumannii isolates were resistant to imipenem,all resistant strains carried blaOXA-51 and blaOXA-23 genes.Conclusion:The infants with underlying diseases or invasive diagnosis and treatment are easy to infect non fermentative bacteria.Most strains of them are drug-resistant and difficult to be treated with long duration and high risk.