布地奈德联合固尔苏治疗早产儿支气管肺发育不良的疗效观察

目的观察布地奈德联合固尔苏治疗早产儿支气管肺发育不良(bronchopulmonary dysplasia,BPD)的临床疗效。方法选取2016-01~2018-12该院出生体重≤1500g或胎龄≤32周、合并有呼吸窘迫综合征(RDS)、需要呼吸支持的早产儿123例,随机分为观察组(61例)和对照组(62例)。观察组采用布地奈德联合固尔苏治疗,对照组采用固尔苏治疗。比较两组治疗前后动脉血气分析[pH、动脉血二氧化碳分压(PaCO2)、动脉血氧分压(PaO2)]、氧合指数(OI)、呼吸机通气时间、吸氧时间变化情况、BPD发生率及其他合并症的发生率情况。结果两组给药前血气分析各项指标比较差异无统计学意义(P>0.05)。两组在给药后2h、48h的pH、PaO2、OI均高于给药前,PaCO2低于给药前,差异均有统计学意义(P<0.05)。观察组在给药后2h、第7天、第2周、第3周时pH、PaO2、OI均高于对照组,PaCO2低于对照组,第4周时PaO2、OI均高于对照组,差异均有统计学意义(P<0.05)。观察组患儿呼吸机通气时间、吸氧时间均短于对照组,BPD发生率低于对照组,差异均有统计学意义(P<0.05)。两组其他合并症发生率差异无统计学意义(P>0.05)。结论布地奈德联合固尔苏较单用固尔苏能更有效改善肺功能、减轻肺炎性损伤,防治BPD,并未增加合并症发生率。

Clinical effect of budesonide combined with curosurf on bronchopulmonary dysplasia in premature infants

Objective To explore the clinical efficacy of budesonide combined with curosurf in treatment of bronchopulmonary dysplasia(BPD)in premature infants.Methods From January 2016 to December 2018,123 premature infants with birth weight≤1500 g or gestational age≤32 weeks who were complicated with respiratory distress syndrome(RDS)and needed respiratory support were randomly divided into observation group(n=61)and control group(n=62).The observation group was treated with budesonide combined with curosurf,and the control group was treated with curosurf.The changes in arterial blood gas analysis[pH,arterial partial pressure of carbon dioxide(PaCO2),arterial partial pressure of oxygen(PaO2)],oxygenation index(OI),duration of mechanical ventilation,duration of oxygen supplementation,incidence of BPD,and incidence of other complications were compared between the two groups before and after treatment.Results There were no significant differences in the indexes of blood gas analysis between the two groups before medication(P>0.05).The levels of pH,PaO2 and OI of the two groups at 2 and 48 hours after medication were significantly higher than those before medication,while the level of PaCO2 was significantly lower than that before medication(P<0.05).The levels of pH,PaO2 and OI of the observation group were significantly higher than those of the control group 2 hours after medication and on the 7th day after medication,and in the 2nd and 3rd weeks after medication,and the level of PaCO2 of the observation group was significantly lower than that of the control group.The levels of PaO2 and OI of the observation group were significantly higher than those of the control group in the 4th week(P<0.05).Compared with the control group,the observation group had shorter duration of mechanical ventilation and shorter duration of oxygen supplementation,and lower incidence of BPD,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence rates of the other complications between the two groups(P>0.05).Conclusion Compared with curosurf alone,budesonide combined with curosurf can effectively improve the lung function,alleviate inflammatory injury of the lungs,prevent and treat BPD,but does not increase the incidence of complications.