摘要
目的探讨早期应用布地奈德对极早产儿支气管肺发育不良(BPD)的影响。方法选择2014年1月至2020年1月濮阳市油田总医院收治的168例极早产儿为研究对象,按照治疗方法将极早产儿分为A组(n=33)、B组(n=56)和C组(n=79)。3组极早产儿均给予呼吸支持、肺泡表面活性物质替代、营养支持、抗感染等常规治疗措施。在常规治疗措施基础上,B组极早产儿于出生第8天给予布地奈德雾化吸入14 d,C组极早产儿于出生第4天给予布地奈德雾化吸入14 d,A组极早产儿不给予布地奈德雾化吸入。分别于治疗前和治疗后检测3组极早产儿静脉血酸碱度(pH)、静脉血氧分压(PvO_(2))、静脉血二氧化碳分压(PvCO_(2))和静脉血氧饱和度(SvO_(2)),记录3组极早产儿总氧疗时间、无创通气时间、有创通气时间和常压吸氧时间,并观察极早产儿BPD和不良反应发生情况。结果治疗前3组极早产儿静脉血pH值、PvO_(2)、PvCO_(2)和SvO_(2)比较差异无统计学意义(P>0.05)。与治疗前比较,治疗后3组极早产儿pH值、PvO_(2)、SvO_(2)显著升高,PvCO_(2)显著降低(P<0.05)。治疗后,B组和C组极早产儿pH值、PvO_(2)、SvO_(2)显著高于A组,PvCO_(2)显著低于A组(P<0.05)。治疗后,C组极早产儿pH值、PvO_(2)、SvO_(2)显著高于B组,PvCO_(2)显著低于B组(P<0.05)。3组极早产儿的有创通气时间、常压吸氧时间比较差异无统计学意义(P>0.05)。B组和C组极早产儿的总氧疗时间、无创通气时间显著短于A组(P<0.05),C组极早产儿的总氧疗时间、无创通气时间显著短于B组(P<0.05)。A组、B组和C组极早产儿BPD发生率分别为18.18%(6/33)、8.94%(5/56)、3.80%(3/79),B组和C组极早产儿BPD发生率显著低于A组(χ^(2)=7.625、5.669,P<0.05),C组极早产儿BPD发生率显著低于B组(χ^(2)=9.164,P<0.05)。A组、B组和C组极早产儿不良反应发生率分别为18.18%(6/33)、19.66%(11/56)、17.72%(14/79),3组极早产儿不良反应发生率比较差异无统计学意义(χ^(2)=1.746,P>0.05)。结论布地奈德可以显著降低极早产儿BPD发生率,改善血气指标,缩短氧疗时间,且早期应用布地奈德的效果更显著。
Objective To investigate the effect of early application of budesonide on bronchopulmonary dysplasia(BPD)in very preterm infants.Methods A total of 168 very preterm infants admitted to Puyang Oilfield General Hospital from January 2014 to January 2020 were selected as the research subjects.The very preterm infants were divided into group A(n=79),group B(n=56)and group C(n=33)according to the treatment methods.The very preterm infants in the three groups were given routine treatment such as respiratory support,alveolar surfactant replacement,nutritional support and anti-infection.On the basis of conventional treatment,the very preterm infants in the group B were treated with budesonide aerosol for 14 days on the 8 th day after birth,while very preterm infants in the group C were treated with budesonide aerosol for 14 days on the 4 th day after birth.The very preterm infants in the group A were not given budesonide aerosol.The venous blood hydrogen ion con centration(pH)value,partial pressure of venous oxygen(PvO_(2)),venous carbon dioxide pressure(PvCO_(2))and venous oxygen saturation(SvO_(2))of the very preterm infants in the three groups were detected before and after treatment.The total oxygen therapy time,noninvasive ventilation time,invasive ventilation time and normal pressure oxygen inhalation time were recorded.The incidence of BPD and adverse reactions of the very preterm infants were observed.Results There was no significant difference in venous blood pH value,PvO_(2),PvCO_(2) and SvO_(2) among the three groups before treatment(P>0.05).Compared with before treatment,the pH value,PvO_(2),SvO_(2) in the three groups were significantly increased,and the PvCO_(2) was significantly decreased(P<0.05).After treatment,the pH value,PvO_(2) and SvO_(2) of the very preterm infants in the group B and group C were significantly higher than those in the group A,and the PvCO_(2) in the group B and group C was significantly lower than that in the group A(P<0.05).After treatment,the pH value,PvO_(2) and SvO_(2) of the very preterm infants in the group C were significantly higher than those in the group B,and PvCO_(2) in the group C was significantly lower than that in the group B(P<0.05).There was no significant difference in invasive ventilation time and normal pressure oxygen inhalation time among the three groups(P>0.05).The total oxygen therapy time and noninvasive ventilation time in the group B and group C were significantly shorter than those in the group A(P<0.05),and the total oxygen therapy time and noninvasive ventilation time in the group C were significantly shorter than those in the group B(P<0.05).The incidence of BPD in the group A,group B and group C was 18.18%(6/33),8.94%(5/56)and 3.80%(3/79),respectively.The incidence of BPD in the group B and group C was significantly lower than that in the group A(χ^(2)=7.625,5.669;P<0.05),and the incidence of BPD in the group C was significantly lower than that in the group B(χ^(2)=9.164,P<0.05).The incidence of adverse reactions in the group A,group B and group C was 18.18%(6/33),19.66%(11/56)and 17.72%(14/79),respectively.There was no significant difference in the incidence of adverse reactions among the three groups(χ^(2)=1.746,P>0.05).Conclusion Budesonide can significantly reduce the incidence of BPD,improve blood gas indexes,shorten the oxygen therapy time in very premature infants,and the early application of budesonide has more significant effect.
作者
刘琳
陈秋芳
付荣
樊姣姣
LIU Lin;CHEN Qiufang;FU Rong;FAN Jiaojiao(Department of Pediatrics,Puyang Oilfield General Hospital,Puyang 457001,Henan Province,China)
出处
《新乡医学院学报》
CAS
2021年第5期468-471,共4页
Journal of Xinxiang Medical University
关键词
极早产儿
支气管肺发育不良
布地奈德
very preterm infant
bronchopulmonary dysplasia
budesonide
