肺表面活性物质联合布地奈德预防极低出生体质量儿支气管肺发育不良的疗效分析

Analysis on the curative effect of pulmonary surfactant combined with budesonide on prevention of bronchopulmonary dysplasia in extremely low birth weight infants

目的分析肺表面活性物质联合布地奈德预防极低出生体质量儿支气管肺发育不良的疗效,为极低出生体质量儿支气管肺发育不良的治疗提供理论依据。方法选取2012年2月-2015年9月黄冈市中心医院新生儿科收治的160例支气管肺发育不良的极低出生体质量儿为研究对象,随机分为对照组(采用表面活性物质治疗)和观察组(采用肺表面活性物质联合布地奈德治疗),每组各80例。比较两组患儿基本情况(胎龄、出生体质量、1 min Apgar评分、5 min Apgar评分、母亲产前使用激素情况、剖宫产情况、多胎情况、胎膜早破情况等),血气分析和氧合指数,呼吸能力恢复时间,临床疗效等。结果两组患儿基本情况比较,差异均无统计学意义(均P>0.05)。治疗前和治疗后1d,两组患儿pH、动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、氧合指数(OI)比较,差异均无统计学意义(均P>0.05)。治疗后3d和治疗后7d,两组患儿pH、PaO_2、PaCO_2、OI比较,差异均有统计学意义(均P<0.05)。不同时间点对照组PaO_2、OI和观察组pH、PaO_2、PaCO_2、OI比较,差异有统计学意义(P<0.05)。观察组患儿呼吸频率恢复时间、机械通气时间、用氧时间明显少于对照组,差异有统计学意义(P<0.05)。两组患儿治疗有效率比较,差异有统计学意义(P<0.05)。两组患儿呼吸窘迫综合征、败血症及其他3种并发症发生率比较,差异有统计学意义(P<0.05)。结论肺表面活性物质联合布地奈德能有效治疗极低出生体质量儿支气管肺发育不良,改善患者的呼吸功能及血气状况。

Objective To analyze the curative effect of pulmonary surfactant combined with budesonide on prevention of bronchopulmonary dysplasia in extremely low birth weight infants,provide a theoretical basis for treatment of extremely low birth weight infants with bronchopulmonary dysplasia.Methods A total of 160 extremely low birth weight infants with bronchopulmonary dysplasia treated in Department of Neonatology in Huanggang Central Hospital from February 2012 to September 2015 were selected and randomly divided into control group(pulmonary surfactant) and observation group(pulmonary surfactant combined with budesonide),80 infants in each group.The basic information(gestational age,birth weight,one-minute Apgar score,5-minute Apgar score,maternal prenatal hormone use,cesarean section,multiple pregnancy,premature rupture of membranes),blood gas analysis and oxygenation indexes,recovery time of breathing capacity,clinical curative effects in the two groups were compared.Results There was no statistically significant difference in basic situation between the two groups(P>0.05).There was no statistically significant difference in p H value,PaO2,PaCO2,and oxygenation index(OI) before treatment and at one day after treatment between the two groups(P> 0.05).There were statistically significant differences in p H value,PaO2,PaCO2,and OI at 3 and 7 days after treatment between the two groups(P<0.05).There were statistically significant differences in PaO2 and OI in control group,p H value,PaO2,PaCO2,and OI in observation group among different time points(P<0.05).The recovery time of respiratory frequency,mechanical ventilation time,and oxygen therapy time in observation group was statistically significantly shorter than that in control group(P<0.05).There was statistically significant difference in effective rate between the two groups(P< 0.05).There were statistically significant differences in the incidence rates of respiratory distress syndrome,septicemia,and other three complications between the two groups(P<0.05).Conclusion Pulmonary surfactant combined with budesonide can effectively treat bronchopulmonary dysplasia in extremely low birth weight infants,improve respiratory function and blood gas analysis indexes.