肺表面活性物质联合布地奈德对急性呼吸窘迫综合征极低出生体质量儿血气分析的影响

Effect of using pulmonary surfactant mixed with budesonide on blood gas analysis in very low birth weight premature with acute respiratory distress syndrome

目的：探讨肺表面活性物质（ PS）联合布地奈德对急性呼吸窘迫综合征（ ARDS）极低出生体质量儿血气分析的影响，并评价用药的治疗效果。方法：2013年12月～2014年11月在大庆油田总医院新生儿科收治的的胎龄＜33周、出生体质量＜1500 g、出生6小时内发生ARDS的早产儿28例，随机分为实验组和治疗组，实验组使用肺表面活性物质（固尔苏）100mg／kg＋布地奈德0．25mg ／kg（男8例，女6例）气管内滴入配合机械通气，治疗组单独使用肺表面活性物质100mg／kg（男9例，女5例）气管内滴注配合机械通气，药物滴注时间在出生60分钟内。监测2组的血气情况。结果：实验组新生儿与治疗组第1、6、12、24小时血气分析pH值、氧分压（ Pa O2）、二氧化碳分压（ pa CO2）、肺泡动脉氧分压差（ AaDO2）比较均有显著差异（ P＜0．05）。结论：用PS联合布地奈德对极低出生体质量儿ARDS血气分析明显改善，改善呼吸困难，缩短吸氧时间，有利于早产儿尽早停氧，降低了肺损伤，减轻了患者的医疗费用，值得临床推广。

Objective：To explore the influence of Blood gas analysis in very low birth weight premature with acute respiratory distress syndrome （ ARDS） after using pulmonary surfactant（PS） mixed with budesonide,and evaluate the therapeutic effect of combination. Methods：Twenty-eight premature infants with gestational age 〈33weeks,birth weight 〈1500 g,whose ARDS occurred within 6 hours after birth were andomly assigned into the experimental group and treatment group in Daqing Oil Field Gneral Hspital from December 2013 to November 2014,Experimental group using lung pulmonary surfactant 100mg/kg ＋budesonide 0.25mg/kg （male 8 cases, female 6 ca-ses） drip endotracheal cooperate with mechanical ventilation.The treatment group used alone lung pulmonary surfactant （ male 9 case,fe-male 5 cases） , 100mg/kg endotracheal drip with mechanical ventilation, drug drip time within 60 minutes after birth.Track two groups of Blood gas analysis.Results：The experimental group a newborn and the treatment group 1, 6, 12, 24 h blood gas analysis of pH value, oxygen partial pressure（Pa O2）, CO2 partial pressure （Pa CO2）, alveolar artery oxygen partial pressure difference （AaDO2） were sig-nificant differences （P 〈0.05）.Conclusion：using PS joint budesonide on ARDS could improve blood gas analysis, improve the diffi-culty in breathing, shorten the time of oxygen, might be advantageous to the premature stop oxygen as soon as possible, reduce the lung injury, relieve the patient＆#39;s medical expenses, worth clinical promotion.