注射用牛肺表面活性剂联合布地奈德防治新生儿支气管肺发育不良的效果

Effect of calf pulmonary surfactant for injection combined with budesonide on prevention and treatment of neonatal bronchopulmonary dysplasia

目的观察注射用牛肺表面活性剂(PS)联合布地奈德防治新生儿支气管肺发育不良(BPD)的效果。方法抽取2018年6月至2019年12月焦作市妇幼保健院收治的86例呼吸窘迫综合征(RDS)患儿,采用随机数字表法分为两组,每组43例。对照组采用常规治疗联合牛肺表面活性剂治疗,观察组采用常规治疗联合牛肺表面活性剂与布地奈德联合治疗,记录两组临床指标,比较两组治疗前(T0)、第1剂用药后2 h(T1)、第2剂用药后2 h(T2)的血气指标包括动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))及pH值、呼吸机应用时间,炎症指标包括白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α),统计BPD及并发症情况。结果观察组呼吸机使用时间及氧疗时间短于对照组(P<0.05);两组住院时间比较,差异未见统计学意义(P>0.05);两组T1、T2时PaCO_(2)水平较T0时降低,PaO_(2)水平较T0时升高,且观察组T1、T2时PaCO_(2)水平低于对照组,PaO_(2)水平高于对照组(P<0.05);两组T1、T2时pH值均较T0时升高,但组间比较差异未见统计学意义(P>0.05);两组T1、T2时IL-6、IL-8、TNF-α水平较T0时降低,且观察组低于对照组(P<0.05);观察组BPD发生率低于对照组(P<0.05);两组动脉导管未闭、败血症、肺出血发生率比较差异未见统计学意义(P>0.05)。结论注射用牛肺表面活性剂联合布地奈德防治RDS患儿BPD,较牛肺表面活性剂单用获益更佳,患儿血气、炎症反应改善,呼吸机使用时间及氧疗时间缩短,BPD发生率降低。

Objective To observe the effect of calf pulmonary surfactant for injection complicated with budesonide in the prevention and treatment of neonatal bronchopulmonary dysplasia(BPD).Methods Eighty-six children with respiratory distress syndrome(RDS)treated in Jiaozuo Maternal and Child Health Care Hospital from June 2018 to December 2019 were selected,they were divide them into two groups by random number table method,43 cases in each group.The control group was treated with conventional therapy+calf pulmonary surfactant for injection,the observation group was treated with conventional treatment+calf pulmonary surfactant for injection complicated with budesonide,the clinical indexes of both groups were recorded,the blood gas indexes including partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO_(2))and pH value,inflammatory indexes including interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factorα(TNF-α)were compared in both groups before treatment(T0),2 hours after the first dose(T1),and 2 hours after the second dose(T2),the occurrence of BPD and complications were counted.Results The use time of ventilator and oxygen therapy in the observation group were shorter than those in the control group(P<0.05);there was no significant difference in hospital stay between the two groups(P>0.05);PaCO_(2) levels at T1 and T2 were decreased than those at T0 in both groups,and PaO_(2) levels were increased at T1 and T2 than at T0,and compared with the control group,the PaCO2 level of the observation group at T1 and T2 was lower and the PaO2 level was higher(P<0.05);the pH values at T1 and T2 were higher than those at T0,but there was no significant difference between the two groups(P>0.05);the levels of IL-6,IL-8 and TNF-αat T1 and T2 in both groups were decreased than those at T0,and those in the observation group were lower than those in the control group(P<0.05);the incidence of BPD in the observation group was lower than that in the control group(P<0.05);there was no significant difference in the incidence of patent ductus arteriosus,sepsis and pulmonary hemorrhage between the two groups(P>0.05).Conclusions Calf pulmonary surfactant for injection complicated with budesonide in the prevention and treatment of BPD in children with RDS is better than calf pulmonary surfactant for injection alone,the blood gas and inflammatory reaction of patients are improved,ventilator use time and oxygen therapy time are shortened,and the incidence of BPD is decreased.