珂立苏联合布地奈德气管内滴入对早产儿支气管肺发育不良的防治效果

Preventive effect of intratracheal instillation of calsurf combined with budesonide on bronchopulmonary dysplasia in premature infants

目的探讨珂立苏联合布地奈德气管内滴入对早产儿支气管肺发育不良(BPD)的防治效果。方法采用前瞻性随机对照研究方法,抽取2021年6月至2022年6月焦作市妇幼保健院收治的50例早产儿作为研究对象,采用信封法分为对照组与观察组,每组25例。对照组采用珂立苏治疗,观察组采用珂立苏+布地奈德治疗。比较两组给药前,给药后1、24 h,撤机前,撤机后1 h的心率、呼吸频率、经皮血氧饱和度(TcSO_(2)),比较两组给药前、给药后1 h、撤机前、撤机后1 h的血气分析指标[动脉血氧分压(PaO_(2)),动脉血二氧化碳分压(PaCO_(2)),吸入氧浓度(FiO_(2)),氧合指数(OI)],统计两组早产儿BPD发生率,并对比BPD严重程度,比较两组用药后1周内不良反应发生情况。结果给药后1、24 h,撤机前,撤机后1 h,观察组心率、呼吸频率均低于给药前,且观察组心率、呼吸频率均低于对照组(P均<0.05);两组TcSO_(2)均高于给药前,且观察组TcSO_(2)高于对照组(P<0.05)。给药后1 h、撤机前、撤机后1 h,观察组PaO_(2)、OI均高于给药前,且观察组高于对照组(P<0.05);观察组PaCO_(2)、FiO_(2)均低于给药前,且观察组低于对照组(P<0.05)。观察组BPD发生率(40.00%,10/25)与对照组(56.00%,14/25)比较,差异未见统计学意义(P>0.05),但观察组出现BPD的严重程度低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率(12.00%,3/25)与对照组(8.00%,2/25)比较差异未见统计学意义(P>0.05)。结论珂立苏联合布地奈德气管内滴入可有效降低早产儿的心率、呼吸频率、PaCO_(2)、FiO_(2),提升TcSO_(2)、PaO_(2)、OI,减轻BPD严重程度,且安全性好。

Objective To investigate the preventive effect of intratracheal instillation of calsurf combined with budesonide on bronchopulmonary dysplasia(BPD)in premature infants.Methods This study was a prospective randomized controlled study.Fifty premature infants treated in Maternal and Child Health Hospital of Jiaozuo from June 2021 to June 2022 were selected as the research subjects,and they were divided into control group and observation group by envelope method,with 25 cases in each group.The control group was treated with calsurf,and the observation group was treated with calsurf combined with budesonide.The heart rate,respiratory rate,transcutaneous oxygen saturation(TcSO_(2))of the two groups were observed before administration,1 hour and 24 hours after administration,before and after withdrawal of the machine.The blood gas analysis indicators,including arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),fraction of inspiration oxygen(FiO_(2)),oxygenation index(OI)of the two groups were observed before administration,1 hour after administration,before and after withdrawal of the machine.The incidence of BPD in premature infants in the two groups were counted,and the severity of BPD of the two groups were compared.The occurrence of adverse reactions within 1 week after medication of the two groups were compared.Results At 1 hour and 24 hours after administration,before withdrawal and 1 hour after withdrawal,the heart rate and respiratory rate of the observation group were lower than those before administration,and the heart rate and respiratory rate of the observation group were lower than those of the control group(all P<0.05).After treatment,the levels of TcSO_(2)in both groups were higher than those before administration,and the level of TcSO_(2)in the observation group was higher than that in the control group(P<0.05).At 1 hour after administration,before withdrawal and 1 hour after withdrawal,the PaO_(2)and OI in the observation group were higher than those before administration,and the two indexes in observation group were higher than those in the control group(P<0.05),moreover,the PaCO_(2)and FiO_(2)in the observation group were lower than those before administration,and the tow indexes in the observation group were lower than those in the control group(P<0.05).There was no statistically significant difference in the incidence of BPD between the observation group(40.00%,10/25)and the control group(56.00%,14/25),P>0.05.However,the severity of BPD in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(12.00%,3/25)and the control group(8.00%,2/25),P>0.05.Conclusions Calsurf combined with budesonide intratracheal instillation can effectively reduce the heart rate,respiratory rate,PaCO_(2)and FiO_(2)of preterm infants,moreover,it can increase TcSO_(2),PaO_(2)and OI,reduce the severity of BPD,with good drug safety.