布地奈德在预防早产儿支气管肺发育不良的应用

Effects of budesonide in the prevention of bronchopulmonary dysplasia

目的观察布地奈德在早产儿支气管肺发育不良(BPD)预防的作用。方法选取2015年8月至2016年10月在安徽医科大学第一附属医院新生儿科住院治疗的极低出生体质量儿56例,胎龄<32周,出生体质量<1 500 g,均为需要机械通气及PS替代治疗的早产儿,采用随机数字表法分为两组,每组28例,分别为对照组:机械通气+PS治疗;观察组:机械通气+PS+布地奈德气管内滴入。观察用药前后撤机拔管时间、高流量氧气吸入时间、停氧时间、在院时间。并观察各组住院期间的不良反应:败血症、坏死性小肠结肠炎、新生儿脑白质软化、支气管肺发育不良发生率。随访两组患者在纠正胎龄为6个月,进行远期随访:肺动脉高压、动脉导管未闭、呼吸道感染、生长落后。结果观察组与对照组比较,撤机拔管时间、高流量氧气使用持续时间、总吸氧时间值明显降低,均差异有统计学意义(P <0. 01);在院时间差异无统计学意义(P> 0. 05);不良反应中,BPD的发生率观察组为0,低于对照组的5/28(P <0. 05);其他不良反应发生率比较差异无统计学意义(P> 0. 05)。远期随访指标,两组差异无统计学意义(P> 0. 05)。结论使用布地奈德能够有效降低早产、极低出生体质量儿机械通气时间和用氧时间,从而降低BPD发生率。

Objective To observe the effects of budesonide for preventing bronchopulmonary dysplasia.Methods 56 patients with extremely low birth weight born from the neonatal department of the First Affiliated Hospital of Anhui Medical University,with gestational age of<32 weeks and the weight of birth<1 500 g,who need ventilation and PS replacement therapy,were randomly divided into 2 groups,with 28 cases in each group,group A:control group,mechanical ventilation+PS therapy.Group B:mechanical ventilation+PS+budesonide van trachea.Observe the time of tube extraction,high flow oxygen inhalation time,oxygen stopping time,and hospital stays.Observe the untoward effect of the groups:ichoremia,necrotizing enterocolitis,neonatal leukodystrophy,and bronchopulmonary dysplasia.Two groups of patients were followed up for six months,followed by long-term follow-up:pulmonary hypertension,arterial ducts,respiratory tract infections,and backward growth.Results Compare group B with group A,the time of tube extraction,high flow oxygen inhalation time,oxygen stopping time were statistically significant(P<0.01).There was no statistically significant difference in hospital stays(P>0.05);In adverse reactions,the incidence of bronchopulmonary dysplasia was statistically significant(0 vs.5,P<0.05).There was no statistically significant difference in the incidence of other adverse reactions(P>0.05)and the others were no statistical difference(P>0.05).Conclusion Using budesonide can reduce the time of oxygen using and mechanical ventilation,and reduce the incidence of BPD of vary low birth weight premature.