肺表面活性物质联合布地奈德预防极低出生体重儿支气管肺发育不良的临床疗效
[Clinical efficacy of pulmonary surfactant combined with budesonide for preventing bronchopulmonary dysplasia in very low birth weight infants].
作者信息
Pan Jing, Chen Ming-Wu, Ni Wen-Quan, Fang Tao, Zhang Hui, Chen Ye, Pan Jia-Hua
机构信息
Department of Pediatrics, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230001, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2017 Feb;19(2):137-141. doi: 10.7499/j.issn.1008-8830.2017.02.002.
OBJECTIVE
To explore the clinical efficacy of intratracheal instillation of pulmonary surfactant (PS) combined with budesonide for preventing bronchopulmonary dysplasia (BPD) in very low birth weight (VLBW) infants.
METHODS
Thirty VLBW infants with gestational age <32 weeks who developed neonatal respiratory distress syndrome (NRDS) (grade III-IV) suffering from intrauterine infection were randomly assigned into a PS + budesonide group and a PS alone group. The changes were compared between the two groups in arterial blood gas indexes, oxygenation index (OI), duration of mechanical ventilation, duration of oxygen supplementation, incidence of BPD, mortality rate at 36 weeks corrected gestational age and incidences of other complications except BPD.
RESULTS
Compared with the PS alone group, the PS+budesonide group had a lower incidence of BPD, shorter duration of mechanical ventilation and oxygen supplementation (P<0.05). On the 2nd to 6th day after treatment, the PS+budesonide group had higher pH value of arterial blood gas and OI and lower carbon dioxide partial pressure compared with the PS alone group (P<0.05). There were no significant differences in the mortality rate at 36 weeks corrected gestational age and the incidences of other complications except BPD between the two groups (P>0.05).
CONCLUSIONS
Intratracheal instillation of PS combined with budesonide can effectively reduce the incidence of BPD in VLBW premature infants with severe NRDS.
目的
探讨气管内滴入肺表面活性物质(PS)联合布地奈德预防极低出生体重(VLBW)儿支气管肺发育不良(BPD)的临床疗效。
方法
将30例胎龄<32周、患新生儿呼吸窘迫综合征(NRDS,Ⅲ-Ⅳ级)且有宫内感染的VLBW儿随机分为PS+布地奈德组和单纯PS组。比较两组动脉血气指标、氧合指数(OI)、机械通气时间、吸氧时间、BPD发生率、矫正胎龄36周时的死亡率及除BPD外其他并发症的发生率。
结果
与单纯PS组相比,PS+布地奈德组BPD发生率更低,机械通气和吸氧时间更短(P<0.05)。治疗后第2至6天,PS+布地奈德组动脉血气pH值和OI更高,二氧化碳分压更低,与单纯PS组比较差异有统计学意义(P<0.05)。两组矫正胎龄36周时的死亡率及除BPD外其他并发症的发生率比较,差异无统计学意义(P>0.05)。
结论
气管内滴入PS联合布地奈德可有效降低重度NRDS的VLBW早产儿BPD的发生率。
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