倍氯米松联合肺表面活性物质防治极低出生体质量儿支气管肺发育不良疗效观察

Effect of Beclomethasone Combined with Pulmonary Surfactant on the Prevention and Treatment of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

目的 探讨倍氯米松联合肺表面活性物质(pulmonarysurfactant,PS)预防极低出生体质量儿支气管肺发育不良(bronchopulmonarydysplasia,BPD)的疗效。方法 选取2017年6月—2020年6月山东潍坊医学院附属潍坊市人民医院收治的体质量<1 500 g且适于胎龄的新生儿呼吸窘迫综合征患儿110例,随机分为2组,治疗组使用倍氯米松联合PS气管内滴入,对照组仅使用PS气管内滴入,记录并分析2组患儿的氧合指数(oxygenindex,OI)、患儿拔管失败率、有创通气率、BPD发生率、有创呼吸机使用时间、用氧时间、住院时间、病死率及相关并发症发生率。结果 治疗组和对照组患儿在给药前及给药第1天的OI无差异;给药第3,5天,治疗组的OI低于对照组;治疗组拔管失败率、有创通气率、BPD发生率、有创呼吸机使用时间、用氧时间、住院时间均低于对照组,差异均有统计学意义(P<0.05),2组在病死率、并发症发生率方面差异没有统计学意义。结论 倍氯米松联合PS气管内滴入能有效降低极低出生体质量儿BPD的发生率,疗效优于单纯PS气管内滴入,不增加相关并发症。

OBJECTIVE To explore the effect of beclomethasone combined with pulmonary surfactant(PS) on the prevention of bronchopulmonary dysplasia(BPD) in very low birth weight infants.METHODS One hundred and ten cases of very low birth weight infants with respiratory distress syndrome with body weight <1 500 g and fit for gestational age admitted to Shandong Weifang People’s Hospital Affiliated to Shandong Weifang Medical University from June 2017 to June 2020 were selected.All of them were randomly divided into 2 groups.The treatment group was treated with beclomethasone and PS intratracheal instillation,while the control group was treated with only PS intratracheal instillation,oxygen index(OI),failure rate of extubation,rate of invasive ventilation,incidence of BPD,time of suction machine use,time of oxygen use,time of hospitalization,mortality and related complications were recorded and analyzed.RESULTS There was no difference in OI between the treatment group and control group before and on the first day of administration.OI in the treatment group was lower than that in the control group on the 3rd,5th day of administration.The extubation failure rate,invasive ventilation rate,BPD incidence in the treatment group was lower than that in the control group,and the ventilator use time,oxygen use time and hospital stay were lower than those in the control group,with significant differences(P<0.05).There was no significant difference in mortality and complication rate between the two groups.CONCLUSION Beclomethasone combined with intratracheal instillation of PS can effectively reduce the incidence of BPD in very low birth weight infants,and the efficacy is better than that of intratracheal instillation of PS without increasing related complications.