猪肺磷脂注射液联合吸入用布地奈德混悬液治疗早产儿重度呼吸窘迫综合征的临床效果分析  

Clinical effect of poractant alfa injection combined with budesonide suspension for inhalation in the treatment of severe respiratory distress syndrome in premature infants

作　　者：汪敏慧[1] 储振宇[1] 朱良梅[1] 戴玉腾[1] 张岚[2] Wang Minhui;Chu Zhenyu;Zhu Liangmei;Dai Yuteng;Zhang Lan(Department of Pediatrics,Anqing Hospital,Anhui Medical University,Anhui,Anqing 246003,China;Department of Neonatal,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]安徽医科大学附属安庆医院儿科,安徽安庆246003 [2]西安交通大学第二附属医院新生儿科,西安710004

出　　处：《中国医学前沿杂志（电子版）》2020年第6期88-92,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：陕西省科学技术厅项目(2018SF-083);安徽医科大学校科研基金项目(2018xkj082)。

摘　　要：目的分析猪肺磷脂注射液联合吸入用布地奈德混悬液治疗早产儿重度呼吸窘迫综合征(respiratory distress synd-rome,RDS)的临床效果。方法选取安徽医科大学附属安庆医院2018年6月至2020年1月收治的58例重度RDS早产儿为研究对象,根据治疗方案不同将其分为观察组(31例,猪肺磷脂注射液联合吸入用布地奈德混悬液治疗)和对照组(27例,单用猪肺磷脂注射液治疗)。比较两组患儿治疗前、治疗1 d和2 d后肺氧合功能[动脉血氧分压(arterial partial pressure of oxygen,PaO2)、肺泡-动脉血氧分压差(alveolar-artery oxygen partial pressure gradient,PA-aO2)、氧合指数(oxygenation index,OI)]、呼吸机参数[吸气峰压(peak inspiratory pressure,PIP)、呼吸频率(respiratory rate,RR)、吸入气氧浓度(fractional concentration of inspired oxygen,FiO2)]、炎性因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白介素-8(interleukin-8,IL-8)、高敏C反应蛋白(high-sensitivity C reactive protein,hs-CRP)]水平,记录并比较两组患儿人工气道机械通气时间、撤机时间、住院天数和并发症发生率。结果治疗1 d和2 d后,两组患儿PaO2均显著高于本组治疗前(均P<0.05),PA-aO2、OI、PIP、RR、FiO2均显著低于本组治疗前(均P<0.05);治疗2 d后,观察组患儿PaO2显著高于对照组(P<0.05)、PA-aO2、OI、PIP、RR、FiO2均显著低于对照组(均P<0.05)。治疗2 d后,两组患儿TNF-α、IL-8、hs-CRP水平均显著低于本组治疗前(均P<0.05),且观察组患儿上述指标水平均显著低于对照组(均P<0.05)。观察组患儿人工气道机械通气时间、撤机时间、住院天数均显著短于对照组(均P<0.05)。两组患儿败血症、新生儿坏死性小肠结肠炎、肺出血、呼吸机相关性肺炎发生率比较差异均无统计学意义(均P>0.05),观察组患儿支气管肺发育不良发生率显著低于对照组(P<0.05),两组均无患儿死亡。结论猪肺磷脂注射液联合吸入用布地奈德混�Objective To explore the clinical effect of poractant alfa injection combined with budesonide suspension for inhalation in the treatment of severe respiratory distress syndrome(RDS)in premature infants.Method Fifty-eight premature infants with severe RDS treated in Anqing Hospital,Anhui Medical University from June 2018 to January 2020 were selected as subjects.According to the different treatment schemes,the premature infants were divided into observation group(n=31,treated with poractant alfa injection combined with budesonide suspension for inhalation)and control group(n=27,treated with poractant alfa injection alone).The pulmonary oxygenation function[arterial partial pressure of oxygen(PaO2),alveolar-artery oxygen partial pressure gradient(PA-aO2),oxygenation index(OI)],ventilator parameters[peak inspiratory pressure(PIP),respiratory rate(RR),fractional concentration of inspired oxygen(FiO2)]and levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-8(IL-8),high-sensitivity C reactive protein(hs-CRP)]were compared between the two groups before treatment,1 day and 2 days after treatment,the time of mechanical ventilation via artifical airway,the time of weaning,the hospital day and the incidence of complications were recorded and compared between the two groups.Result After 1 day and 2 days of treatment,PaO2 in both groups were significantly higher than those before treatment(all P<0.05),while PA-aO2,OI,PIP,RR and FiO2 were significantly lower than those before treatment(all P<0.05).After 2 days of treatment,PaO2 in observation group was significantly higher than that in control group(P<0.05),and PA-aO2,OI,PIP,FiO2 were significantly lower than those in control group(all P<0.05).After 2 days of treatment,the levels of TNF-α,IL-8 and hs-CRP in the two groups were significantly lower than those before treatment(all P<0.05),and the levels of the above indexes in observation group were significantly lower than those in control group(all P<0.05).The time of mechanical ventilation via artifica

关 键 词：早产儿 呼吸窘迫综合征 重度 猪肺磷脂注射液 吸入用布地奈德混悬液 疗效 

分 类 号：R722.6[医药卫生—儿科]