肺表面活性物质联合布地奈德气管内滴入预防极低出生体重早产儿支气管肺发育不良的疗效观察

发布时间：2018-05-23 20:37

本文选题：布地奈德 + 珂立苏　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的探讨肺表面活性物质(珂立苏)联合布地奈德气管内滴入预防极低出生体重早产儿支气管肺发育不良的临床疗效,为有效预防极低出生体重早产儿支气管肺发育不良提供临床依据。方法选取胎龄32周的患有感染和炎症的呼吸窘迫综合征(NRDS)(III或IV级)的极低出生体重儿共30例,随机分成PS+布地奈德组(15例)和PS组(15例)。比较两组患儿产前用激素、Apgar评分、出生体重、性别、胎龄和分娩方式等一般资料,比较两组给药前后不同时间点的生命体征(呼吸、心率、血压、经皮测血氧饱和度)、血气分析(pH,PaO2,PaCO2)、氧合指数(OI)、吸氧浓度(FiO2)、呼吸机使用时间、吸氧时间、BPD的发生率、纠正胎龄36周时死亡率以及其他并发症(如高血糖、高血压、气胸、动脉导管未闭、颅内出血、坏死性小肠结肠炎等)的发生率,并进行统计分析。结果 (1)两组患儿一般情况相比较,在产前用激素、Apgar评分、出生体重、性别、胎龄和分娩方式等方面均无统计学差异(P0.05);(2)两组给药前后不同时间点的生命体征(呼吸、心率、血压、经皮测血氧饱和度)差异无统计学意义(P0.05);(3)给药前和给药后第一天,两组血气分析(pH,PaO2,PaCO2)、氧合指数(OI)、吸氧浓度(FiO2)差异均无统计学意义(P0.05);给药后第2-6天,PS+布地奈德组OI值和pH值均高于PS组,PaCO2值和FiO2值均低于PS组,且差异均有统计学意义(P0.05),而这两组患儿中的PaO2的值无统计学差异(P0.05);(4)PS+布地奈德组患儿BPD发生率明显低于PS组;呼吸机使用时间和吸氧时间明显短于PS组(P0.05);(5)两组间纠正胎龄36周时死亡率以及其他并发症均无统计学差异(P0.05)。结论 PS联合布地奈德气管内滴入与单独PS气管内滴入相比,能明显改善患有感染和炎症的重度呼吸窘迫综合征的极低出生体重早产儿的通气功能和换气功能,显著降低支气管肺发育不良的发生率,近期并发症和死亡率无差异。
[Abstract]:Objective to investigate the clinical efficacy of pulmonary surfactant (cerect) combined with budesonide intratracheal infusion in the prevention of bronchopulmonary dysplasia in very low birth weight premature infants, and to provide a clinical basis for the effective prevention of bronchopulmonary dysplasia in very low birth weight premature infants. Methods the respiratory distress of 32 weeks of gestational age with infection and inflammation was selected. A total of 30 very low birth weight infants (NRDS) (III or IV) were randomly divided into PS+ budesonide group (15 cases) and PS group (15 cases). The general data of prenatal hormone, Apgar score, birth weight, sex, gestational age and delivery mode were compared between the two groups, and the vital signs (respiration, heart rate, blood pressure, transdermal delivery) were compared between the two groups at different time points. Blood oxygen saturation), blood gas analysis (pH, PaO2, PaCO2), oxygenation index (OI), oxygen concentration (FiO2), ventilator time, oxygen inhalation time, the incidence of BPD, the mortality of 36 weeks of fetal age, and the incidence of other complications (such as hyperglycemia, hypertension, pneumothorax, patent ductus arteriosus, intracranial hemorrhage, necrotizing enterocolitis, etc.), and the incidence of the incidence of other complications (such as hyperglycemia, hypertension, pneumothorax, patent ductus arteriosus, intracranial hemorrhage, necrotizing enterocolitis, etc.) Results (1) there was no statistical difference between the two groups. There was no statistical difference in prenatal hormone, Apgar score, birth weight, sex, gestational age and delivery mode (P0.05). (2) there was no significant difference in the vital signs (respiration, heart rate, blood pressure, and percutaneous oxygen saturation) between the two groups (3) (3); (3) The two groups of blood gas analysis (pH, PaO2, PaCO2), oxygenation index (OI) and oxygen uptake (FiO2) were not statistically significant (P0.05) before and on the first day after administration, and the OI and pH values of PS+ budesonide group were higher than those in the PS group on the 2-6 day after the administration, and both PaCO2 and FiO2 values were lower than those in the two groups. There was no statistical difference in the value of 2 (P0.05); (4) the incidence of BPD in PS+ budesonide group was significantly lower than that in group PS; the use time and the oxygen absorption time of the ventilator were significantly shorter than that of the PS group (P0.05); (5) the mortality rate and other complications were not statistically different (P0.05) for the 36 weeks of fetal age correction between groups (P0.05). Conclusion PS combined with budesonide intratracheal instillation and individual PS gas. Instillation can significantly improve the ventilatory function and ventilation function of the extremely low birth weight premature infants with severe respiratory distress syndrome with infection and inflammation, and significantly reduce the incidence of bronchopulmonary dysplasia, and there is no difference in recent complications and mortality.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R722.6

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