不同剂型布地奈德对新生儿呼吸窘迫综合征的疗效观察

Effect of Different Dosage Forms of Budesonide on Neonatal Respiratory Distress Syndrome

目的:探究不同剂型布地奈德对新生儿呼吸窘迫综合征(NRDS)患儿的影响。方法:我院收治的106例NRDS患儿均给予肺表面活性物质(PS)治疗,根据患儿所用不同剂型布地奈德分为3组:持续喷入组、单剂喷入组和液体剂组;对比3组患儿血气指标变化、谷胱甘肽(GSH)水平变化、支气管肺发育不良(BPD)情况,记录呼吸困难消失时间、发绀消失时间、辅助通气持续时间及住院时间。结果:患儿接受治疗后,持续喷入组氧分压(PaO2)、二氧化碳分压(PaCO2)和氧合指数(PaO2/FiO2)均优于单剂喷入组与液体剂组(P<0.05);液体剂组PaCO2、PaO2/FiO2优于单剂喷入组(P<0.05)。治疗后,3组患儿血清GSH水平均高于治疗前(P<0.05),持续喷入组高于单剂喷入组与液体剂组(P<0.05);持续喷入组呼吸困难消失时间、发绀消失时间、辅助通气持续时间及住院时间均短于单剂喷入组与液体剂组(P<0.05);持续喷入组BPD发生率低于单剂喷入组(P<0.05)。结论:气雾剂型布地奈德持续喷入治疗新生儿NRDS效果更理想,能改善患儿血气指标,提高GSH水平,减轻临床症状,促进患儿康复。

Objective:To investigate the effect of different dosage forms of budesonide on neonatal respiratory distress syndrome(NRDS).Methods:106 NRDS patients in our hospital were treated with pulmonary surfactant(PS).According to the different dosage forms of budesonide used,they patients were divided into three groups,continuous spray group,single-dose spray group and liquid agent group.The changes of blood gas index,glutathione(GSH)level,bronchopulmonary dysplasia(BPD),the time of dyspnea,cyanosis,auxiliary ventilation and hospitalization were recorded and analyzed.Results:Partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2)and oxygenation index(PaO2/Fi O2)in the continuous spray group were significantly better than those in the single-dose spray group and the liquid agent group(P<0.05).PaCO2 and PaO2/Fi O2 in liquid agent group were better than those in single-dose spray group(P<0.05).The serum GSH level in the three groups after treatment was significantly higher than that before treatment(P<0.05).The serum GSH in continuous spray group was significantly higher than that in the single-dose spray group and liquid agent group(P<0.05).The dyspnea disappearance time,cyanosis disappearance time,assisted ventilation time and length of hospitalization in the continuous spray group were significantly shorter than those in the single-dose spray group and the liquid agent group(P<0.05).The incidence of BPD in continuous spray group was significantly lower than that in single-dose spray group(P<0.05).Conclusion:Continuous aerosol budesonide spray shows improved effectiveness in the treatment of neonatal NRDS.It can improve the blood gas index,increase the level of GSH,alleviate clinical symptoms and promote the recovery of patients.