布地奈德持续雾化吸入联合肺表面活性物质对新生儿呼吸窘迫综合征的临床疗效分析-现代医学

布地奈德持续雾化吸入联合肺表面活性物质对新生儿呼吸窘迫综合征的临床疗效分析

单位：海南省妇幼保健院新生儿科, 海南海口 570206

分类号：R722.1

出版年·卷·期（页码）：2018·46·第十一期（1243-1246）

摘要：

目的：探讨布地奈德持续雾化吸入联合肺表面活性物质治疗新生儿呼吸窘迫综合征（RDS）对支气管肺发育不良的影响。方法：选取2016年2月至2017年8月本院收治的144例RDS新生儿，使用随机数字表法将其分为对照组和观察组（每组72例）。对照组采用肺表面活性物质固尔苏，以100 mg·kg^-1气管导管滴入；观察组在对照组基础上使用布地奈德，以0.25 mg·kg^-1持续雾化吸入，疗程3 d。结果：治疗后观察组PaO₂和pH值分别为（84.53±12.26）mmHg和7.38±0.17，显著高于对照组的（71.42±11.31）mmHg和7.26±0.15（P<0.05）；观察组PaCO₂为（36.58±3.14）mmHg，显著低于对照组的（43.47±4.23）mmHg（P<0.05）。观察组有效率为86.11%（62/72），显著高于对照组的68.06%（49/72）（P<0.05）；辅助机械通气时间为（6.31±1.43）d，显著短于对照组的（11.27±3.16）d（P<0.01）；重复使用肺表面活性物质患儿占8.33%（6/72），显著低于对照组的26.39%（19/72）（P<0.05）；改为有创机械通气患儿占9.72%（7/72），显著低于对照组的27.78%（20/72）（P<0.05）；治疗后支气管肺发育不良患儿占12.50%（9/72），显著低于对照组的23.61%（17/72）（P<0.05）。结论：布地奈德持续雾化吸入联合肺表面活性物质治疗新生儿RDS，临床疗效显著，可显著降低支气管肺发育不良的发生率。

Objective:To detect the effect of budesonide inhalation combined with pulmonary surfactant on bronchopulmonary dysplasia after RDS in newborns. Methods:144 newborns with RDS were enrolled in this study. They were divided into control group(n=72) and observation group(n=72). The control group was given crossruff 100 mg·kg^-1 tracheal catheter infusion. Budesonide 0.25 mg·kg^-1 was additionally used for continuous inhalation in the observation group for 3 days. Results:After treatment, PaO₂ and pH in observation group was (84.53±12.26) mmHg and 7.38±0.17,which was significantly higher than that of (71.42±11.31) mmHg and 7.26±0.15 in the control group (P<0.05). After treatment, PaCO₂ was (36.58±3.14) mmHg in the observation group,which was lower than that of (43.47±4.23) mmHg in the control group(P<0.05). The effective rate in observation group was 86.11%(62/72), which was significantly higher than that of 68.06%(49/72)in the control group(P<0.05). The time of auxiliary mechanical ventilation in the observation group was (6.31±1.43) d, which was significantly shorter than that of (11.27±3.16) d in the control group (P<0.01). The reuse of pulmonary surfactant in the observation group was 8.33% (6/72), which was significantly lower than that of 26.39% (19/72) in the control group (P<0.05). The need to the invasive mechanical ventilation in the observation group was 9.72% (7/72), which was significantly lower than that of 27.78% (20/72) in the control group (P<0.05). The incidence of bronchopulmonary dysplasia in the observation group was 12.50% (9/72), which was significantly lower than that of 23.61% (17/72) in the control group(P<0.05). Conclusion:Continuous inhalation of budesonide combined with pulmonary surfactant in the treatment of neonatal RDS has a significant clinical effect of reducing the incidence of bronchopulmonary dysplasia.

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