布地奈德联合肺表面活性物质对重症呼吸窘迫综合征早产儿近期疗效、血氧指标及支气管肺发育不良发生风险的影响

Effects of Budesonide Combined with Pulmonary Surfactant on Short-Term Efficacy,Blood Oxygenation Index and Risk of Bronchopulmonary Dysplasia in Premature Infants with Severe Respiratory Distress Syndrome

目的:探讨布地奈德联合肺表面活性物质(PS)对重症呼吸窘迫综合征(RDS)早产儿近期疗效、血氧指标及支气管肺发育不良(BPD)发生风险的影响。方法:选取我院2015年8月至2017年12月收治的重症RDS早产儿共110例,按随机数字表法分为对照组和观察组各55例,对照组在常规治疗基础上单用PS,观察组在对照组治疗基础上加用布地奈德气管内滴注,比较两组患儿有创通气时间、撤机时间、住院总时间及治疗前后PaO2、PaCO2、OI、BPD发生率和其他主要并发症发生率。结果:观察组有创通气时间、撤机时间及住院总时间均短于对照组,差异有统计学意义(P<0.05)。治疗后观察组患儿PaO2水平较对照组升高,PaCO2和OI较对照组降低,差异均有统计学意义(P<0.05)。观察组中重度BPD发生率(16.36%)显著低于对照组(54.55%,P<0.05)。两组患儿其他主要并发症发生率比较差异无统计学意义(P>0.05)。结论:布地奈德联合PS治疗重症RDS早产儿可快速有效促进肺功能恢复,缩短通气时间和总住院时间,并有助于降低中重度BPD发生风险。

Objective:To investigate the effects of budesonide combined with pulmonary surfactant( PS) on short-term efficacy,blood oxygenation index and risk of bronchopulmonary dysplasia( BPD) in premature infants with severe respiratory distress syndrome( RDS).Methods:Totally 110 premature infants with severe RDS admitted into our hospital from Aug. 2015 to Dec. 2017 were extracted to be divided into the control group and the observation group via the random number table,with 55 cases in each group. The control group received PS alone on the basis of conventional treatment,while the observation group was given budesonide intratracheal infusion on the basis of the control group. The invasive ventilation time,withdrawal time,total length of stay,level of PaO2 and PaCO2,OI,incidence of BPD,and incidence of other major complications were compared between two groups. Results:The invasive ventilation time,the withdrawal time and the total length of stay in the observation group were shorter than those in the control group,with statistically significant difference( P<0. 05). After treatment,the level of PaO2 in the observation group was higher than that in the control group,and the level of PaCO2 and OI were lower than that in the control group,with statistically significant differences( P < 0. 05). The incidence of severe BPD in the observation group( 16. 36%) was significantly lower than that in the control group( 54. 55%,P<0. 05).There was no significant difference in the incidence of other major complications between two groups( P > 0. 05). Conclusion:Budesonide combined with PS in the treatment of severe RDS in preterm infants can quickly and effectively promote lung function recovery,shorten the ventilation time and total length of stay,and help to reduce the risk of moderate and severe BPD.