雾化吸入布地奈德防治早产儿拔除气管插管后喉头水肿的临床疗效

Clinical Observation of Nebulized Budesonide in the Prevention and Treatment of Laryngeal Edema in Premature Infants after Extubating Endotracheal Intubation

目的探讨雾化吸入布地奈德防治早产儿拔除气管插管后喉头水肿的临床疗效。方法选取2018年5月至2020年12月于梧州市红十字会医院行气管插管呼吸机辅助通气的早产儿120例作为研究对象,按随机数字表法分为对照组与观察组,各60例。对照组拔管前静脉予以地塞米松及拔管后予以肾上腺素雾化吸入治疗,观察组拔管后予以布地奈德雾化吸入治疗,比较两组患儿48 h内拔管成功率、喉头水肿发生率、临床疗效、喉头水肿症状持续时间、呼吸频率、心率。结果观察组患儿拔管成功率为100.00%,明显高于对照组的81.67%(P<0.05);观察组喉头水肿发生率为21.67%,明显低于对照组的43.33%(P<0.05)。治疗后,观察组喉头水肿患儿治疗有效率为100.00%,明显高于对照组的57.69%(P<0.05);观察组喉头水肿症状持续时间、呼吸频率、心率明显低于对照组(P<0.05)。结论雾化吸入布地奈德防治早产儿拔除气管插管后喉头水肿的临床疗效显著,可提高拔管成功率,降低喉头水肿发生率,缩短喉头水肿症状持续时间,降低呼吸频率和心率。

Objective To investigate the clinical efficacy of nebulized budesonide in the prevention and treatment of laryngeal edema in premature infants extubated after endotracheal intubation.Methods A total of 120 premature infants with endotracheal intubation admitted to Wuzhou Red Cross Hospital were selected as the research objects and were randomly divided into an observation group(n=60)and a control group(n=60).The control group was treated with intravenous dexamethasone before extubation and adrenaline inhalation after extubation.The observation group was treated with budesonide aerosol inhalation after extubation.The success rate of extubation,the incidence of laryngeal edema,clinical effects,the duration of laryngeal edema,respiratory rate,heart rate were compared between the 2 groups within 48 h.Results The success rate of extubation in the observation group was 100.00%,which was significantly higher than that in the control group(81.67%)(P<0.05).The incidence of laryngeal edema in the observation group was 21.67%,which was significantly lower than that in the control group(43.33%)(P<0.05).After treatment,the effective rate of children with laryngeal edema in the observation group was 100.005%,which was significantly higher than that in the control group(57.69%)(P<0.05).The duration of laryngeal edema,respiratory rate and heart rate in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Nebulized budesonide inhalation is effective in the prevention and treatment of laryngeal edema in premature infants extubated after endotracheal intubation,which can increase the success rate of decannulation,reduce the incidence of laryngeal edema,shorten the duration of laryngeal edema symptoms,and reduce respiratory frequency and heart rate.