早期吸入布地奈德治疗对足月儿胎粪吸入的作用:一项随机对照研究。
The role of early inhaled budesonide therapy in meconium aspiration in term newborns: a randomized control study.
作者信息
Garg Neelmani, Choudhary Mukesh, Sharma Deepak, Dabi Dhanraj, Choudhary Jagveer Singh, Choudhary Sushil Kumar
机构信息
a General Hospital , Swaimadhopur , Rajasthan , India .
b Department of Medical and Paediatric Oncology , GCRI , Ahmedabad , Gujarat , India .
出版信息
J Matern Fetal Neonatal Med. 2016;29(1):36-40. doi: 10.3109/14767058.2014.985202. Epub 2014 Dec 3.
OBJECTIVE
To study the clinical spectrum of Meconium aspiration syndrome babies and to find out the efficacy of early nebulized steroids (Budesonide) in the clinical course and outcome (morbidity and mortality) of neonates with meconium aspiration: randomized controlled trial.
METHOD AND MATERIAL
A total of 78 neonates were included in the study. After randomization, intervention group received nebulization with Budesonide (0.5 mg dissolved in 2.5-ml sterile normal saline within 2 h of birth and second dose was given at 12 h of birth) whereas controls were nebulized with normal saline. All neonates were accessed for serial respiratory distress score (Downe's score), requirement (dependence) of oxygen (in days), duration of neonatal intensive-care unit (NICU) stay, any complication and their final outcome.
RESULTS
The mean days of oxygen requirement for the cases and controls were 1.79 and 3.46, respectively (p < 0.001). The mean respiratory rate in intervention group up to the age of 5 d was significantly less (p value < 0.01). There was significant difference in mean Downe's score and mean duration of NICU stay in intervention group.
CONCLUSION
Budesonide nebulization in meconium aspiration results in significant early improvement in general condition (early improvement in respiratory distress and early normalization of Downe's score) of the newborn with lesser oxygen requirement, thus early discharge from NICU but has no impact on final outcome.
目的
研究胎粪吸入综合征患儿的临床谱,并探讨早期雾化吸入类固醇(布地奈德)对胎粪吸入新生儿临床病程及结局(发病率和死亡率)的疗效:随机对照试验。
方法与材料
本研究共纳入78例新生儿。随机分组后,干预组在出生后2小时内接受布地奈德雾化吸入(0.5毫克溶解于2.5毫升无菌生理盐水中,出生后12小时给予第二剂),而对照组接受生理盐水雾化吸入。对所有新生儿进行连续呼吸窘迫评分(唐恩评分)、氧气需求(天数)、新生儿重症监护病房(NICU)住院时间、任何并发症及其最终结局的评估。
结果
病例组和对照组的平均吸氧天数分别为1.79天和3.46天(p<0.001)。干预组在5日龄前的平均呼吸频率显著更低(p值<0.01)。干预组的平均唐恩评分和平均NICU住院时间存在显著差异。
结论
胎粪吸入时雾化吸入布地奈德可使新生儿的一般状况显著早期改善(呼吸窘迫早期改善,唐恩评分早期正常化),吸氧需求减少,从而可早期从NICU出院,但对最终结局无影响。