布地奈德联合肺表面活性物质气管内滴入治疗早产儿支气管肺发育不良

张 成云, 郝瑞 影*
郑州市第一人民医院新生儿科 河南郑州 450000

摘要

摘要：目的观察布地奈德联合肺表面活性物质（PS）气管内滴入治疗早产儿支气管肺发育不良（BPD）的临床疗效。方法选取2017年01月-2022年01月我院住院超28天仍需有创机械通气的BPD患儿61例，分成三组，观察组：布地奈德+PS混合液组（21例）；布地奈德组：单用布地奈德混悬液组（20例）；PS组：单用PS组（20例）。比较三组患儿血气分析变化、有创呼吸机使用时间、吸氧时间、住院时间及常见并发症情况。结果布地奈德+PS组患儿有创通气时间、吸氧时间、住院时间均低于对照组，差异有统计学意义；给药后观察组pH、PaO2、OI均高于对照组，PaCO2均低于对照组，且差异均有统计学意义（P<0.05）；三组患儿间并发症差异无统计学意义。结论布地奈德联合PS在治疗BPD患儿中疗效肯定。

关键词

关键词：布地奈德；肺表面活性物质；早产儿；支气管肺发育不良

参考

[1] Herting E. Bronchopulmonary dysplasia: pathogenesis, risk factors and early prevention strategies[J]. Chin Med J （ Engl）, 2010, 123（20）: 2955-2957.[2] Wang J, Liu X, Zhu T, et al. Analysis of neonatal respiratory distress syndrome among different gestational segments[J]. Int J Clin Exp Med, 2015, 8（9）: 16273-16279.[3] 邓黎静，彭华保，龚晓琴等. 布地奈德联合肺表面活性物质治疗重度呼吸窘迫综合征对支气管肺发育不良的影响[J]. 中华新生儿科杂志，2017，32（9）：361-364.[4] 潘静，陈名武，倪文泉等. 肺表面活性物质联合布地奈德预防极低出生体重儿支气管肺发育不良的疗效观察[J]. 中国当代儿科杂志，2017，19（2）137-140.[5]Jobe AH，Bancalari E. Bronchpulmonary dysplasia.Am J Respir Crit Care Med，2001，163：1723-1729.[6]Iyengar A,Davis JM.Drug therapy for prevention and treatment of bronchopulmonary dysplasia [J].Front pharmacol,2015,6:12.[7]Hascoet JM ,Picancl JC,Ligi .I,et al.Late surfactant administration in very preterm neonates with prolonged respiratory distress and pulmonary clinical trial [J/OL].JAMA Pediatr,2016,170(4):365-372.[8] Yeh TF．Chen CM。Wu SY．et a1．1ntratracheal administration of budssonlde ／ surfactant to prevent hrenehopulmonary dysplasia I[J] ． Am Respir Grit Care Med．2016,l93(1)：86-95．DOI：l0．1164／recto．201505 861OC.[9] Yeh TF，Lin HC，Chang CH，et a1．Early intratracheal instillation of budesonide using surfactant as a vehicle to prevent chronic lung disease in preterm infants：a pilot study[J]．Pediatrics，2008，12l(5)：e 1310—1318．DOI：10．1542／peds．2007—1973.[10]吴甜，母得志；早产儿支气管肺发育不良的研究进展[J].中华妇幼临床医学杂志（电子版），2016，6（12）：339-342.[11]Ghanta S,Leaman.KT,Christou H. An update.on pharmacologic approaches to bronchopulmouary dysplasia[J].Semin perinatol,2013,37(2):115-123.[12]Shab SS.Ohlsson A,Halliday HL,et al.Inhaled versus systemic corticosteroids for preventing chonic lung disease in ventilated very low brith weight preterm neonates [J].Cochrane Datebase Syst Rev,2012,5:CD002058.[13]Barrette AM, Roberts JK, Chapin C, et al. Antiinflammatory effects of budesonide in human fetal lung[J]. Am J Respir Cell Mol Biol, 2016, 55(5): 623-632.[14] Yeh TF, Chen CM, Wu SY, et al. Intratracheal administration of budesonide/surfactant to prevent bronchopulmonary dysplasia [J]. Am J Respir Crit Care Med, 2016, 193(1): 86-95.[15] Saugstad OD,Aune D,Optimal oxygenation of extremely low birth weight infants:a meta-analysis and systematic review of the oxygen saturation target studies [J] .Neonat target studies[J].Nenatology,2014,105(1):55-63.DOI:10.1159/000356561.[16] Sweet DG,Carnielli V,Greisen G,et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants -2013 update[J]. Neonatology,2013,103(4):353-368,DOI:10.1159/000349928.