布地奈德混悬液氧驱雾化吸入防治早产儿支气管肺发育不良的临床效果

目的 探讨布地奈德混悬液氧驱雾化吸入法防治早产儿支气管肺发育不良(BPD)的临床效果.方法 回顾性分析2012年9月至2015年9月本科新生儿重症监护病房收治的90例符合条件的早产儿的资料.根据治疗方案,分为对照组(n=46,患儿接受常规治疗)和观察组0=44,患儿在常规治疗基础上接受布地奈德混悬液氧驱雾化吸入治疗).患儿治疗2个疗程,每个疗程7d.比较两组患儿血气指标、体重、BPD发生率.结果 两组治疗前血气指标PO2、PCO2及体重无统计学差异(P＞0.05).治疗2周后,两组PCO2有所下降,PO2有所上升,体重也有明显提升,观察组变化幅度更大.两组治疗后血气指标、体重比较有统计学差异(P＜0.05).观察组总吸氧时间显著缩短[(12.5±3.1)d vs.(16.3±4.7)d,t=3.877,P=0.028].观察组BPD发病率显著降低[11.4％ (5/44) vs.30.4％ (14/46),x2=4.911,P=0.038].观察组未见糖皮质激素治疗可能引发的短期副作用.观察组44例患儿中有16例已随访至2岁以上,未见脑瘫等远期并发症.结论 对合并有新生儿呼吸窘迫综合征(NRDS)的早产儿,给予布地奈德混悬液氧驱雾化吸入治疗,可显著改善血气指标,提高体重增长速度,缩短吸氧时间,降低BPD发生率.

Oxygen atomized inhalation of budesonide in prevention and treatment of bronchopulmonary dysplasia in premature infants

Objective To evaluate the preventive and curative effect of oxygen atomized inhalation of budesonide for bronchopulmonary dysplasia (BPD) in premature infants.Methods The data of 90 premature infants admitted into the neonatal intensive care unit of our hospital from September,2012 to September,2015 were retrospectively analyzed.According to the treatments they received,the premature infants were grouped into a control group (n=46,routine treatment only) and an observation group (n=44,routine treatment and oxygen atomized inhalation of budesonide).Both groups were treated 2 courses,7 days as a course.The blood gas indexes,body weight,and incidence of BPD were analyzed and compared between these two groups.Results There were no statistical differences in PO2,PCO2,and body weight between these two groups before the treatment (P＞0.05).After 2 courses of treatment,the PCO2 decreased,the PO2 and body weight increased in both groups,but they were better in the observed group than in the control group,with statistical differences between these two groups (P＜0.05).The overall oxygen-uptake time was obviously shorter and the incidence of BPD was much lower in the observation group than in the control group [(12.5±3.1)d vs.(16.3±4.7) d,t=-3.877,P=-0.028;11.4％ (5/44) vs.30.4％ (14/46),x 2=4.911,P=-0.038].Among the 44 cases of the observation group,16 were followed up until they were 2 years old,no long-term complications,such as cerebral palsy,were found.Conclusions For premature infants with neonatal respiratory distress syndrom (NRDS),the additional treatment of oxygen atomized inhalation of budesonide could improve blood gas indexes and body weight and reduce the overall oxygen-uptake time and the incidence of BPD.