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[皮质类固醇在支气管肺发育不良中的应用]

[The use of corticosteroids in bronchopulmonary dysplasia].

作者信息

Wesselink M W, van den Anker J N, Sauer P J

机构信息

Academisch Ziekenhuis Rotterdam-Sophia Kinderziekenhuis, afd. Neonatologie.

出版信息

Ned Tijdschr Geneeskd. 1991 May 25;135(21):943-6.

PMID:2052111
Abstract

In order to study the effect of dexamethasone on the ventilatory function of 13 neonates with bronchopulmonary dysplasia, a retrospective investigation was carried out in the University Hospital Rotterdam, Sophia Children's Hospital, Neonatal Intensive Care Unit. Thirteen preterm neonates, 7 boys and 6 girls, born after 26 4/7-32 weeks' gestation with birth weights between 680 and 1800 g were studied. At the age of 21 days they all showed clinical and radiological evidence of BPD and despite maximal therapy they deteriorated during the last week before entering into the study. The potentially successful dexamethasone schedule of Avery was started. After four days' therapy only 3 patients out of 13 were still on the ventilator. Ventilatory support could be stopped in all neonates after 4.7 (SD 2.0) days. No hypertension or hyperglycaemia was seen. Only 1 child had a positive blood culture; this was successfully treated. In the end two children died. The use of corticosteroids in bronchopulmonary dysplasia in this study showed a positive short-term effect. Long-term sequelae and the risk of infection are still controversial.

摘要

为研究地塞米松对13例支气管肺发育不良新生儿通气功能的影响,在鹿特丹大学医院索菲亚儿童医院新生儿重症监护病房进行了一项回顾性调查。研究对象为13例早产儿,7例男孩,6例女孩,孕26 4/7 - 32周出生,出生体重680 - 1800克。在21日龄时,他们均表现出支气管肺发育不良的临床和影像学证据,尽管进行了最大程度的治疗,但在进入研究前的最后一周病情仍恶化。于是开始采用艾弗里可能成功的地塞米松治疗方案。治疗4天后,13例患者中只有3例仍需呼吸机支持。所有新生儿在4.7(标准差2.0)天后均可停止通气支持。未观察到高血压或高血糖。只有1例患儿血培养呈阳性,已成功治疗。最终有2例患儿死亡。本研究中使用皮质类固醇治疗支气管肺发育不良显示出短期积极效果。长期后遗症和感染风险仍存在争议。

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