肺泡表面活性物质联合布地奈德治疗新生儿重症呼吸衰竭  

Pulmonary surfactant combined with budesonide for treating severe neonatal respiratory failure

作　　者：李花[1] 钱向明[1] 李怡[1] LI Hua;QIANG Xiangmin;LI Yi(Department of Neonatology,Miayang Municipal Maternal and Child Health Care Hospital,Mianyang,Sichuan 621000,China)

机构地区：[1]四川省绵阳市妇幼保健院新生儿科,621000

出　　处：《重庆医学》2020年第24期4176-4179,共4页Chongqing medicine

摘　　要：目的比较肺泡表面活性物质(PS)及PS联合布地奈德(BUD)治疗新生儿重症呼吸衰竭疗效及安全性。方法选取2018年1月至2020年1月在该院新生儿科住院接受机械通气(CMV)且使用PS或PS联合BUD治疗的重症呼吸衰竭患儿64例,分为对照组(CMV+PS)和观察组(CMV+PS+BUD),观察两组治疗后的血气结果、并发症发生情况及医疗结局。结果两组治疗前血气结果比较,差异无统计学意义(P>0.05),但观察组治疗后氧指数(OI)下降优于对照组(P<0.05);两组治疗后血气结果及OI比较,差异有统计学意义(P<0.05);观察组较对照组总CMV时间及用氧时间缩短,差异有统计学意义(P<0.05);观察组较对照组气胸、肺出血、呼吸机相关性肺炎(VAP)发生率低,但差异无统计学意义(P>0.05),两组新生儿持续肺动脉高压(PPHN)比较,差异有统计学意义(P<0.05)。结论PS联合BUD治疗可改善重症呼吸衰竭新生儿预后。Objective To compare the efficacy and safety between pulmonary surfactant(PS)and PS combined with budesonide(BUD)for treating neonatal severe respiratory failure.Methods Sixty-four neonatal cases of severe respiratory failure receiving mechanical ventilation(MV)and using PS or PS combined with BUD in the neonatal department of this hospital from January 2018 to January 2020 were selected and divided into the control group(CMV+PS)and observation group(CMV+PS+BUD).The blood gas results,complications occurrence situation and medical outcomes were observed in the two groups.Results The blood gas results before treatment had no statistical difference between the two groups(P>0.05).But the oxygen index(OI)decrease after treatment in the observation group was superior to that in the control group(P<0.05);the blood gas results and OI after treatment had statistical difference between the two groups(P<0.05);the total MV time and oxygen use time in the observation group were shortened compared with the control group,and the difference was statistically significant(P<0.05);the occurrence rates of pneumothorax,pulmonary hemorrhage and ventilator associated pneumonia(VAP)in the observation group were low compared with the control group,but the difference was not statistically significant(P>0.05);the persistent pulmonary hypertension of newborn(PPHN)had statistical difference between the two groups(P<0.05).Conclusion PS combined with BUD can improve the prognosis in the neonates with severe respiratory failure.

关 键 词：肺表面活性物质 布地奈德 新生儿 重症呼吸衰竭 

分 类 号：R722.12[医药卫生—儿科]