无创高频震荡通气联合早期布地奈德雾化吸入预防早产儿支气管肺发育不良的疗效

Efficacy non-invasive high frequency oscillatory ventilation combined with early budesonide nebulization rehabilitation to prevent BPD in premature infants

目的探讨无创高频震荡通气(N-HFOV)联合早期布地奈德雾化吸入预防早产儿支气管肺发育不良(BPD)的临床意义。方法选取我院分娩的早产儿新生儿呼吸窘迫综合征(RDS)61例,随机分为2组。对照组30例,入院后即刻给予经鼻持续气道正压通气(NCPAP)呼吸支持。研究组31例,在常规治疗的基础上给予N-HFOV,患儿撤离呼吸机后早期(生后7~10天)给予布地奈德雾化吸入治疗。结果研究组BPD发生率、呼吸机相关性肺炎(VAP)发生率、机械通气例数、总用氧时间均低于对照组(P<0.05)。研究组24h、48h二氧化碳分压显著低于对照组(P<0.05);研究组血糖升高例数、真菌感染率均低于对照组(P<0.05)。结论N-HFOV联合早期布地奈德雾化吸入可有效预防早产儿BPD的发生,改善早产儿预后。

Objective To explore the clinical significance of non-invasive high-frequency oscillatory ventilation(N-HFOV)combined with early budesonide nebulization inhalation to prevent bronchopulmonary dysplasia(BPD)in premature infants.Methods Totally 61 premature infants with respiratory distress syndrome(RDS)in our hospital were selected and randomly divided into study group(31 cases)and control group(30 cases).The study group was given non-invasive high-frequency oscillatory ventilation on the basis of conventional treatment,and Budesonide aerosol inhalation was given in the early stage(7-10 days after birth)after weaning from the ventilator.The control group was given NCPAP respiratory support immediately after admission.Results The incidence of BPD,ventilatorassociated pneumonia(VAP),the number of cases of mechanical ventilation,and the total oxygen use time in the study group were lower than those in the control group(P<0.05).The partial pressure of CO2 at 24 hand 48 hin study group was obviously lower than that in control group(P<0.05).The number of cases with elevated blood glucose and the rate of fungal infection in the study group were lower than those in the control group(P<0.05).Conclusion N-HFOV combined with early budesonide nebulization can effectively prevent BPD in premature infants and improve their prognosis.