雾化吸入布地奈德联合乙酰半胱氨酸治疗新生儿呼吸窘迫综合征的临床疗效  

Clinical efficacy of nebulized budesonide combined with acetylcysteine in the treatment of neonatal respiratory distress syndrome YANG Xin,

作　　者：杨欣 邱建平 朱小丽 QIU Jian-Ping;ZHU Xiao-Li(Department of Neonatology,First Affiliated Hospital of Gannan Medical University,Ganzhou 341000,Jiangxi,China)

机构地区：[1]赣南医科大学第一附属医院新生儿科,江西赣州341000 [2]寻乌县人民医院儿科

出　　处：《吉林医学》2025年第1期149-152,共4页Jilin Medical Journal

基　　金：赣州市指导性科技计划[项目编号:GZ2021ZSF094]。

摘　　要：目的:探讨雾化吸入布地奈德与乙酰半胱氨酸联合治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效及其对患儿血气分析指标、炎性因子水平的影响。方法:选取赣南医学院第一附属医院2021年9月~2023年6月收治的符合纳入标准的NRDS患儿46例,根据随机数字表法分为两组,对照组23例,试验组23例。入院后给予所有患儿经鼻持续气道正压通气,若经鼻持续气道正压通气压力≥6 cm H_(2)O,吸入氧浓度>0.3,则予天然型肺表面活性物质替代治疗;予对照组患儿雾化吸入布地奈德进行治疗,试验组则在对照组基础上结合乙酰半胱氨酸进行治疗;两组均进行持续治疗,直至疾病稳定或患儿出现终点事件(死亡)。比较两组患儿治疗5 d后的临床疗效,治疗前与治疗5 d后的血气分析指数、炎性因子水平以及支气管肺发育不良的发生情况和无创辅助通气时间。结果:治疗5 d后试验组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗5 d后两组酸碱度(PH)、动脉血氧分压(PaO_(2))较治疗前均有显著升高,且治疗后试验组显著高于对照组,差异有统计学意义(P<0.05);通过5 d治疗,两组动脉血二氧化碳分压(PaCO_(2))均明显降低,且治疗5 d后试验组显著低于对照组,差异有统计学意义(P<0.05)。治疗5 d后两组白细胞计数(WBC)、降钙素原(PCT)及C反应蛋白(CRP)水平较治疗前显著降低,差异有统计学意义(P<0.05);且治疗后试验组显著低于对照组,差异有统计学意义(P<0.05)。试验组患儿无创辅助通气时间显著短于对照组,差异有统计学意义(P<0.05)。两组支气管肺发育不良发生情况比较,差异无统计学意义(P>0.05)。结论:布地奈德与乙酰半胱氨酸雾化吸入联合治疗NRDS的疗效确切,能显著改善患儿血气分析,同时调节炎性因子水平,缩短无创辅助通气时间,安全性较好。Objective To explore the clinical efficacy of nebulized budesonide combined with acetylcysteine in the treatment of NRDS and its impact on blood gas analysis indicators and inflammatory cytokine levels in pediatric patients.Method According to the random number table method,NRDS patients admitted to the First Affiliated Hospital of Gannan Medical College from September 2021 to June 2023 who met the inclusion criteria were divided into two groups(a control group of 23 cases and an experimental group of 23 cases).After admission,all children were given continuous positive airway pressure ventilation through the nose.If the nasal continuous positive airway pressure ventilation pressure was≥6 cm H_(2)O and the inhaled oxygen concentration was>0.3,natural pulmonary surfactant replacement therapy was given;The control group was treated with nebulized budesonide inhalation,while the experimental group was treated with acetylcysteine in combination with the above foundation;Both groups received continuous treatment until the disease stabilized or the patient experienced an endpoint event(death).Compare the clinical efficacy of two groups of pediatric patients after 5 days of treatment,including blood gas analysis index,inflammatory factor levels,incidence of bronchopulmonary dysplasia,and non-invasive assisted ventilation time before and after treatment.Results After 5 days of treatment,the clinical efficacy of the experimental group was more significant than that of the control group(P<0.05).After 5 days of treatment,the pH and arterial oxygen partial pressure of both groups significantly increased compared to before treatment,and the experimental group was significantly higher than the control group after treatment(P<0.05);After 5 days of treatment,both groups showed a significant decrease in arterial carbon dioxide partial pressure,and after 5 days of treatment,the experimental group was significantly lower than the control group(P<0.05).After 5 days of treatment,the white blood cell count,procalcitonin and C-reacti

关 键 词：新生儿呼吸窘迫综合征 吸入用乙酰半胱氨酸 布地奈德混悬液 

分 类 号：R722.1[医药卫生—儿科]