布地奈德联合肺表面活性物质预防早产儿支气管肺发育不良的应用价值分析  

Application value of budesonide combined with pulmonary surfactant in preventing bronchopulmonary dysplasia in premature infants

作　　者：曹冰冰 罗玲云[1] 陈葵欢 程建婷 CAO Bing-bing;LUO Ling-yun;CHEN Kui-huan(Foshan Gaoming District People's Hospital,Foshan 528500,China)

机构地区：[1]佛山市高明区人民医院

出　　处：《中国实用医药》2019年第20期25-27,共3页China Practical Medicine

摘　　要：目的探讨布地奈德联合肺表面活性物质预防早产儿支气管肺发育不良(BPD)的应用价值。方法100例合并新生儿呼吸窘迫综合征(NRDS)的早产儿,按照就诊顺序随机分为对照组和观察组,每组50例。对照组患儿采用肺表面活性物质进行治疗,观察组患儿在对照组基础上联合布地奈德进行治疗。观察比较两组患儿的住院时间、吸氧时间、呼吸机使用时间、支气管肺发育不良发生率、干预后呼吸机参数及干预前后血气指标。结果干预后,两组患儿的动脉血氧分压(PaO2)、pH值均明显高于干预前,动脉血二氧化碳分压(PaCO2)明显低于干预前,且观察组的PaO2、p H值分别为(145.25±8.52)mm Hg(1 mm Hg=0.133 kPa)、(7.36±0.05),均明显高于对照组的(91.25±4.86)mm Hg、(7.32±0.06),PaCO2为(46.28±4.58)mm Hg,明显低于对照组的(49.36±4.28)mm Hg,差异均有统计学意义(P<0.05)。观察组患儿干预后各呼吸机参数吸入氧浓度(FiO2)、呼吸频率(RR)、呼气末正压(PEEP)及吸气峰压(PIP)分别为(45.00±5.00)%、(42.15±5.28)次/min、(3.95±0.91)cm H2O(1 cm H2O=0.098 kPa)、(18.55±0.51)cm H2O,均明显低于对照组的(66.00±7.00)%、(44.28±3.96)次/min、(4.35±0.84)cm H2O、(22.97±2.31)cm H2O,差异均有统计学意义(P<0.05)。观察组患儿干预后的住院时间、吸氧时间、呼吸机使用时间均明显短于对照组,支气管肺发育不良发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论对合并新生儿呼吸窘迫综合征的早产儿采用肺表面活性物质联合布地奈德进行治疗,有助于降低支气管肺发育不良发生率,能够明显改善患儿的血气指标,降低呼吸机参数,缩短住院时间及吸氧时间,值得进一步在临床推广应用。Objective To discuss the application value of budesonide combined with pulmonary surfactant in preventing bronchopulmonary dysplasia(BPD)in premature infants.Methods A total of100 premature infants with neonatal respiratory distress syndrome(NRDS)as study subjects were divided by visiting order into control group and observation group,with 50 cases in each group.The control group was treated with pulmonary surfactant,and the observation group was treated with budesonide on the basis of the control group.Observation and comparison were made on hospitalization time,oxygen inhalation time,duration of ventilator use,incidence of bronchopulmonary dysplasia,ventilator parameters after intervention and blood gas indexes before and after intervention in two groups.Results After intervention,both groups had obviously higher arterial partial pressure of oxygen(PaO2)and pH than those before treatment,and obviously lower arterial partial pressure of carbon dioxide(PaCO2)than those before intervention.The observation group had obviously higher PaO2 and pH respectively as(145.25±8.52)mm Hg(1 mm Hg=0.133 kPa)and(7.36±0.05)than(91.25±4.86)mm Hg and(7.32±0.06)in the control group,and obviously lower PaCO2 as(46.28±4.58)mm Hg than(49.36±4.28)mm Hg in the control group.Their difference was statistically significant(P<0.05).After intervention,the observation group had obviously lower fractional inhaled oxygen concentration(FiO2),respiratory rate(RR),positive endexpiratory pressure(PEEP)and peak inspiratory pressure(PIP)respectively as(45.00±5.00)%,(42.15±5.28)times/min,(3.95±0.91)cm H2 O(1 cm H2 O=0.098 kPa)and(18.55±0.51)cm H2 O,which were all obviously lower than(66.00±7.00)%,(44.28±3.96)times/min,(4.35±0.84)cm H2 O and(22.97±2.31)cm H2 O in the control group,and their difference was statistically significant(P<0.05).After intervention,the observation group had obviously shorter hospitalization time,oxygen inhalation time,and duration of ventilator use than the control group,and obviously lower incidence of bronchopu

关 键 词：早产儿 支气管肺发育不良 布地奈德 肺表面活性物质 

分 类 号：R722.6[医药卫生—儿科]