布地奈德联合肺表面活性物质气管内给药对呼吸窘迫综合征并极低出生体重早产儿潮气呼吸肺功能的影响  

Effect of budesonide combined with pulmonary surfactant intratracheal administration on tidal breathing pulmonary function in very-low-birth-weight preterm infants with combined respiratory distress syndrome

作　　者：廖智行 饶红萍[2] LIAO Zhi-xing;RAO Hong-ping(Department of Neonatology,Medical College of Shantou University,Shantou 515041,China)

机构地区：[1]汕头大学医学院,515041 [2]惠州市中心人民医院新生儿病区,516001

出　　处：《中国现代药物应用》2023年第5期1-4,共4页Chinese Journal of Modern Drug Application

基　　金：惠州市科技局的社会发展领域项目立项课题(项目编号:2022CZ010438)。

摘　　要：目的研究布地奈德联合肺表面活性物质(PS)气管内给药对呼吸窘迫综合征并极低出生体重早产儿潮气呼吸肺功能的影响。方法63例呼吸窘迫综合征并极低出生体重早产儿,根据治疗方法不同分为实验组(33例)与对照组(30例)。实验组给予布地奈德联合PS气管内给药治疗,对照组给予PS气管内给药治疗。比较两组测肺功能时体重、纠正胎龄40周潮气呼吸肺功能指标、临床相关指标及并发症发生情况。结果实验组纠正胎龄40周的达峰时间比(TPTEF/TE)(27.35±5.91)%、达峰容积比(VPTEF/VE)(27.71±5.90)%高于对照组的(24.26±5.53)%、(24.49±5.43)%,差异有统计学意义(P<0.05)。两组测肺功能时体重、潮气量(VT)、呼吸频率(RR)、吸气时间(TI)、呼气时间(TE)、达到峰流速时间(TPTEF)、达到呼气峰流速时所呼出气体容积(VPTEF)比较,差异无统计学意义(P>0.05)。实验组有创通气时间、无创通气时间、呼吸机使用总时间、总用氧时间、住院时间短于对照组,差异有统计学意义(P<0.05)。实验组颅内出血(IVH)发生率18.2%低于对照组的43.3%,差异有统计学意义(P<0.05)。两组高血糖、动脉导管未闭(PDA)、气胸、新生儿坏死性小肠结肠炎(NEC)、败血症、视网膜病变(ROP)、脑室周围软化(PVL)发生率比较,差异无统计学意义(P>0.05)。结论对呼吸窘迫综合征并极低出生体重早产儿进行布地奈德联合PS气管内给药的方式进行干预,可有效缩短早产儿撤机时间,改善潮气呼吸功能,降低IVH发生率。Objective To study the effect of budesonide combined with pulmonary surfactant(PS)intratracheal administration on tidal breathing pulmonary function in very-low-birth-weight preterm infants with combined respiratory distress syndrome.Methods A total of 63 very-low-birth-weight preterm infants with combined respiratory distress syndrome were divided into experimental group(33 cases)and control group(30 cases)according to different treatment methods.The experimental group was treated with budesonide and PS intratracheal administration,and the control group was treated with PS intratracheal administration.Both groups were compared in terms of body weight at the time of pulmonary function measurement,tidal breathing pulmonary function parameters at 40 weeks of corrected gestational age,clinical relevant indicators,and occurrence of complications.Results The ratio of time to peak tidal expiratory flow to total expiratory time(TPTEF/TE)and ratio of the volume to peak tidal expiratory flow to total expiratory time(VPTEF/VE)at 40 weeks of corrected gestational age were(27.35±5.91)%and(27.71±5.90)%in the experimental group,which were higher than(24.26±5.53)%and(24.49±5.43)%in the control group,and the differences were statistically significant(P<0.05).The differences in body weight,internal tidal volume(VT),respiratory rate(RR),inspiratory time(TI),expiratory time(TE),time to peak flow(TPTEF),and volume to peak tidal expiratory flow(VPTEF)at the time of measuring pulmonary function between the two groups were not statistically significant(P>0.05).The invasive ventilation time,non-invasive ventilation time,total days on ventilator,total oxygen use time,and hospital stay in the experimental group were shorter than those in the control group,and the differences were statistically significant(P<0.05).The incidence of intracranial hemorrhage(IVH)in the experimental group was 18.2%,which was lower than 43.3%in the control group,and the difference was statistically significant(P<0.05).The incidence of hyperglycemia,patent du

关 键 词：呼吸窘迫综合征 极低出生体重 布地奈德 肺表面活性物质 气管内给药 早产儿 潮气呼吸肺功能 

分 类 号：R563.8[医药卫生—呼吸系统] R722.6[医药卫生—内科学]