布地奈德联合气管插管-肺表面活性物质-拔管使用持续气道正压通气技术在早产儿呼吸窘迫综合征的应用价值  

Application Value of Budesonide Combined with Endotracheal Intubation,Active Substances on the Lung Surface,Extubation and Continuous Positive Airway Pressure Ventilation in Premature Infants with Respiratory Distress Syndrome

作　　者：朱曦怡[1] 李柳青[1] 李福兵 谢钰雁 韦秀珍[1] ZHU Xi-yi;LI Liu-qing;LI Fu-bing(Department of Pediatrics,the People's Hospital of Guangxi Zhuatig Autonomous Regin,Nanning 530021,China)

机构地区：[1]广西壮族自治区人民医院儿科,广西南宁530021

出　　处：《医学临床研究》2021年第7期975-977,982,共4页Journal of Clinical Research

基　　金：广西卫生厅自筹经费科研课题(合同号:Z20180701)。

摘　　要：[目的]探讨布地奈德联合气管插管-肺表面活性物质-拔管使用持续气道正压通气技术(INSURE)在早产儿呼吸窘迫综合征的应用价值。[方法]回顾性分析2018年1月至2019年12月本院收治的30例NRDS早产儿的临床资料,根据治疗方法的不同将其分为观察组和对照组,每组各15例。两组均应用INSURE技术治疗,观察组联合应用布地奈德。比较两组患儿血气分析指标,肺表面活性物质(PS)再次使用率、平均撒机时间、平均总吸氧时间、支气管肺发育不全(BPD)发生率及严重程度,并记录比较两组患儿治疗期间并发症发生情况。[结果]给药后12 h.24 h,两组患儿pH.血氧分压(PaO_(2))水平均高于给药后4 h,且观察组高于对照组;两组患儿二氧化碳分压(PaCO_(2))水平低于给药后4 h,且观察组低于对照组,差异均有统计学意义(均P<0.05)。观察组患儿PS再次使用率、BPD发生率及中-重度BPD所占比例均低于对照组,差异均有统计学意义(P<0.05)。观察组CPAP治疗后平均撒机、平均总吸氧时间均低于对照组,差异有统计学意义(P<0.05)。两组患儿视网膜病、晚发型脓毒血症.坏死性小肠结肠炎、脑室周围-脑室内出血发生率比较,差异均无统计学意义(P>0.05)。[结论]布地奈德联合INSURE技术应用于早产儿呼吸窘迫综合征治疗中可有效改善患儿血气指标,提高治疗效果,减少早产儿BPD发生,未增加治疗期间并发症的风险,值得推广应用。[Objective]To explore the use of Application value of budesonide combined with endotracheal intubation,active substances on the lung surface,extubation and continuous positive airway pressure ventilation in premature infants with respiratory distress syndrome.[Methods]The clinical data of 30 premature infants with NRDS treated in our hospital from January 2018 to December 2019 were retrospectively analyzed.According to different treatment methods,they were divided into observation group and control group,with 15 cases in each group.Both groups were treated with insert technology,and the observation group was treated with budesonide.The blood gas analysis indexes,PS reuse rate,average weaning time,average total oxygen inhalation time,incidence and severity of BPD were compared between the two groups,and the complications during treatment were recorded and compared between the two groups.[Results]At 12 h and 24 h after administration,the levels of ph and PaCO_(2) in the two groups were higher than those at 4 h after adminis-tration,and those in the observation group were higher than those in the control group;The level of PaCO_(2) in the two groups was lower than 4 hours after administration,and the level of PaCO_(2) in the observation group was lower than that in the control group(meanP<0.05).The reuse rate of PS,the incidence of BPD and the proportion of moderate to severe BPD in the observation group were lower than those in the control group(P<0.05).After CPAP treatment,the average withdrawal time and average total oxygen inhalation ime in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of retinopathy,late onset sepsis,necrotizing enterocolitis and periventricular intraventricular hemorrhage between the two groups(P>0.05).[Conclusion]Budesonide combined with insert technology in the treatment of respiratory distress syndrome of preterm infants can effectively improve the blood gas index of children,improve the treatment effect,reduce

关 键 词：呼吸窘迫综合征 新生儿/治疗 正压呼吸 肺表面活性剂 布地奈德/治疗应用 

分 类 号：R725.638[医药卫生—儿科]