肺表面活性物质、布地奈德联合鼻塞式持续气道正压通气治疗新生儿呼吸窘迫综合征的临床效果

Clinical effect of pulmonary surfactant,Budesonide combined with nasal obstruction continuous positive airway pressure ventilation in the treatment of neonatal respiratory distress syndrome

目的探讨肺表面活性物质、布地奈德联合鼻塞式持续气道正压通气治疗新生儿呼吸窘迫综合征(NRDS)的临床效果。方法选取2017年1月~2018年12月我院收治的90例NRDS患儿作为研究对象,按照随机数字表法分为对照组与观察组,每组各45例。对照组在常规措施治疗基础上予以肺表面活性物质联合鼻塞式持续气道正压通气治疗,观察组在对照组治疗基础上加用布地奈德治疗,两组的治疗时间均为7 d。比较两组治疗前后血气相关指标、呼吸机使用时间、吸氧时间、住院时间及支气管肺发育不良(BPD)发生率。结果两组治疗前血pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(OI)等血气相关指标比较,差异无统计学意义(P>0.05)。两组治疗后的pH值、PaO2、OI高于治疗前,PaCO2低于治疗前,差异有统计学意义(P<0.05),且观察组治疗后的pH值、PaO2、OI高于对照组,而观察组治疗后的PaCO2低于对照组,差异有统计学意义(P<0.05);观察组呼吸机使用时间、吸氧时间及住院时间均短于对照组,差异有统计学意义(P<0.05),且BPD发生率低于对照组,差异有统计学意义(P<0.05)。结论肺表面活性物质、布地奈德联合鼻塞式持续气道正压通气可明显改善NRDS早产儿血气相关指标,缩短呼吸机使用时间、吸氧时间及住院时间,明显降低BPD发生率。

Objective To investigate the clinical effect of pulmonary surfactant,Budesonide combined with nasal obstruction continuous positive airway pressure ventilation in the treatment of neonatal respiratory distress syndrome(NRDS).Methods A total of 90 children with NRDS admitted to our hospital from January 2017 to December 2018 were selected as the research objects.According to the random number table method,they were divided into the control group and the observation group,with 45 cases in each group.The control group was treated by pulmonary surfactant combined with nasal obstruction continuous positive airway pressure ventilation on the basis of routine treatment measures,and the observation group was treated by Budesonide on the basis of the control group,the treatment time of two groups were all 7 days.The blood gas related indexes between the two groups before and after treatment were compared,and the use time of ventilator,oxygen intake time,hospitalization time and incidence of bronchopul monary dysplasia(BPD)between the two groups were compared.Results The blood gas related indicators such as blood pH value,arterial partial pressue of oxygen(PaO2),arterial pressure of carbon dioxide(PaCO2),oxygenation index(OI)were compared between the two groups before treatment,and the differences were not statistically significant(P>0.05).After treatment,the pH value,PaO2,OI of the two groups were higher than those of before treatment,while the PaCO2 was lower than that of before treatment,the differences were statistically significant(P<0.05),and the pH value,PaO2,OI of the observation group after treatment were higher than those of the control group,and the PaCO2 of the observation group after treatment was lower than that of the control group,the differences were statistically significant(P<0.05).The duration of ventilator use,oxygen intake and hospital stay in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05),the incidence of BPD was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion The treatment of pulmonary surfactant,Budesonide combined with nasal obstruction continuous positive airway pressure ventilation can significantly improve the blood gas related indicators of NRDS premature infants,shorten the duration of ventilator use,oxygen intake and hospital stay,and significantly reduce the incidence of BPD.