布地奈德联合猪肺磷脂注射液治疗重度新生儿呼吸窘迫综合征效果观察

Effect of budesonide combined with poractant alfa injection in the treatment of severe neonatal respiratory distress syndrome

目的观察布地奈德联合猪肺磷脂注射液治疗重度新生儿呼吸窘迫综合征的效果。方法选取2018年1月到2019年11月本院收治的98例重度新生儿呼吸窘迫综合征患儿,按摸球法分为联合组及对照组,各49例,对照组接受机械通气及猪肺磷脂注射液治疗,联合组在对照组基础上联合布地奈德雾化吸入。观察2组患儿治疗效果、治疗前后肺功能及炎症水平。结果联合组总有效率(86%)较对照组高(67%,P<0.05)。2组患儿治疗前动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、氧合指数(OI)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6差异无统计学意义(P>0.05)。治疗后2组PaO2、OI均较治疗前增高(P<0.05),PaCO2均较治疗前降低(P<0.05)。治疗后联合组pO2、OI较对照组显著增高,pCO2较对照组显著降低,差异均有统计学意义(P<0.05)。治疗后2组TNF-α、IL-6均较治疗前降低(P<0.05)。治疗后联合组TNF-α、IL-6较对照组降低,差异均具有统计学意义(P<0.05)。结论布地奈德联合猪肺磷脂注射液可提高重度新生儿呼吸窘迫综合征疗效,改善肺功能,降低炎症反应水平。

Objective To observe the effect of budesonide combined with porcine poractant alfa injection on severe neonatal respiratory distress syndrome.Methods From January 2018 to November 2019,98 children with severe neonatal respiratory distress syndrome treated in our hospital were selected and divided into the combination group and the control group according to the touching method,with 49 cases in each group.The control group received mechanical ventilation and poractant alfa injection,the combination group was combined with budesonide inhalation based on the treatment of the control group.The treatment effect,lung function and inflammation level in the two groups were observed.Results The total effective rate of the combined group(86%)was higher than that of the control group(67%,P<0.05).There were no significant differences in PaO2,PaCO2,OI,TNF-α,and IL-6 before treatment between the two groups(P>0.05).After treatment,PaO2 and OI were higher in both groups than those before treatment(P<0.05),and PaCO2 was lower than that before treatment(P<0.05).After treatment,PaO2 and OI in the combination group were significantly higher than those in the control group,and PaCO2 was significantly lower than that in the control group,the differences were statistically significant(P<0.05).After treatment,TNF-αand IL-6 were lower in both groups than those before treatment(P<0.05).After treatment,the TNF-αand IL-6 in the combination group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Budesonide combined with poractant alfa injection can improve the efficacy of severe neonatal respiratory distress syndrome,improve lung function,and reduce the level of inflammatory response.