布地奈德空气压缩驱动雾化吸入对早产儿机械通气喉损伤的临床疗效研究

目的:探讨布地奈德混悬液空气压缩驱动雾化吸入对早产儿机械通气后喉损伤的临床疗效.方法:本院新生儿科85例机械通气后喉损伤的早产儿,随机分治疗组44例和对照组41例,治疗组撤机拔管后予布地奈德混悬液空气压缩驱动雾化,对照组给予地塞米松超声雾化及琥珀氢化可的松静脉滴注,观察两组患儿喉梗阻症状消失时间、动脉血气指标及并发症情况.结果:治疗组吸气性凹陷时间和声嘶(喘鸣)消失时间为(2.00±0.95)d和(2.15±1.20)d,短于对照组的(2.51±1.32)d和(2.85±1.65)d,两组比较差异有统计学意义(P＜0.05)；治疗组气促消失时间为(2.56±1.74)d,短于对照组的(2.90±1.84)d,两组比较差异无统计学意义(P＞0.05).两组患儿拔管后及24h动脉血气监测均大致正常,差异无统计学意义(P＞0.05)；雾化期间治疗组并发症的发生率低于对照组,差异无统计学意义(P＞0.05).结论:布地奈德混悬液空气压缩驱动雾化吸入能更好改善早产儿机械通气后喉梗阻临床症状,稳定患儿动脉血氧分压和二氧化碳分压,对早产儿机械通气后喉损伤有一定的治疗作用.

Efficacy of Budesonide Inhalation in Preterm Infants with Laryngeal Injury after Mechanical Ventilation

Objective: To explore the clinical effect of budesonide inhalation for preterm infants after the laryngeal injury by mechanical ventilation.Methods: Randomly 85 cases of preterm infants in hospital after a throat injury caused by mechanical ventilation were divided into the treatment group(44 patients) and the control group(41 patients).The treatment group was given budesonide suspension inhalation after extubation,while the control group was given ultrasonic atomization of dexamethasone and intravenous hydrocortisone succinate.The time of laryngeal obstruction disappearing,arterial blood gas and complications were observed.Result: The disappearance time of suction depressions and hoarseness or wheezing in the treatment group was(2.00±0.95) days and(2.15±1.20) days respectively,while(2.51±1.32) days and(2.85±1.65) days in the control group.The difference between the two groups was statistically significant(P<0.05).The short breath time in the treatment group was(2.56±1.74) days,shorter than(2.90±1.84) days in the control group.There was no statistical difference in two groups(P>0.05).The arterial blood gas monitoring results in two groups at the first spray after extubation and after 24 hours were generally normal.There was no statistical difference in two groups(P>0.05).Conclusions: Budesonide suspension inhalation could improve the clinical symptoms and signs of laryngeal obstruction after mechanical ventilation and stabilize the PaO2 and PaCO2 of the premature.It can be used for laryngeal injury after mechanical ventilation for preterm infants.