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
|
摘要
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,PaO_2,PaCO_2,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,PaO_2,PaCO_2,and OI at 3 and 7 days after treatment between the two groups(P<0.05).There were statistically significant differences in PaO_2 and OI in control group,p H value,PaO_2,PaCO_2,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.
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,PaO_2,PaCO_2,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,PaO_2,PaCO_2,and OI at 3 and 7 days after treatment between the two groups(P<0.05).There were statistically significant differences in PaO_2 and OI in control group,p H value,PaO_2,PaCO_2,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.
引文
[1]谭伟,雷瑯嬛,姚丽平,等.不同时间采用肺表面活性物质治疗早产儿呼吸窘迫综合征的疗效比较[J].中华妇幼临床医学杂志(电子版),2017,13(4):455-460.
[2]王枫,乔艳梅,陈丽琴.持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的效果[J].中国妇幼保健,2017,32(13):2924-2927.
[3]黄列,徐锡,纪永佳,等.布地奈德联合固尔苏对支气管肺发育不良防治的研究[J].宁夏医学杂志,2017,39(6):511-512.
[4]王模奎,董文斌,黄薇,等.早期抢救性使用牛肺表面活性物质对早产儿严重呼吸窘迫综合征的疗效[J].儿科药学杂志,2017,23(6):12-15.
[5]余红蕾.经鼻持续气道正压通气对肺表面活性物质治疗新生儿呼吸窘迫综合征效果的影响[J].解放军医药杂志,2017,29(5):75-78.
[6]王红霞,徐心坦,张晓慧.不同时机应用经鼻持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效观察[J].中国妇幼保健,2017,32(7):1565-1568.
[7]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质量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):137-141.
[8]吴杰斌,周彬,翟敬芳,等.不同无创通气模式联合肺表面活性物质在新生儿呼吸窘迫综合征初始呼吸支持的临床应用[J].中华临床医师杂志(电子版),2017,11(3):383-387.
[9]谭秀贞,吴时光,张建华,等.猪肺表面活性物质联合布地奈德混悬液气管内滴入治疗新生儿胎粪吸入综合征的疗效观察[J].中国当代儿科杂志,2016,18(12):1237-1241.
[10]Dagan MP,Hall SB.The equilibrium spreading tension of pulmonary surfactant[J].Langmuir,2015,31(48):13063-13067.
[11]陈奕江,张水堂,杨润娜.生后7天内气道内应用布地奈德对早产儿支气管肺发育不良发生率影响的系统评价和Meta分析[J].中国循证儿科杂志,2016,11(4):259-264.
[12]张媛柯,肖群文,李琪,等.早产儿支气管肺发育不良发生率及临床危险因素分析[J].中国新生儿科杂志,2016,31(3):198-200.
[13]柯华,李占魁,于西萍,等.不同剂型布地奈德联合肺表面活性物质治疗新生儿呼吸窘迫综合征疗效的比较[J].中国当代儿科杂志,2016,18(5):400-404.
[14]Lanka GK,Yu JJ,Gong S,et al.Ig A modulates respiratory dysfunction as a sequela to pulmonary chlamydial infection as neonates[J].Pathog Dis,2016,74(3):10-13.
[15]邓黎静.布地奈德联合肺泡表面活性物质气管内滴入治疗早产儿RDS的临床研究[D].衡阳:南华大学,2016.
[16]吴晨,邓春.支气管肺发育不良发病机制研究进展[J].儿科药学杂志,2016,22(4):57-60.
[17]林云,贾雁平,石霖,等.早产儿支气管肺发育不良防治研究[J].中国妇幼保健,2015,30(35):6246-6248.
[18]林云,贾雁平.布地奈德雾化吸入辅助治疗早产儿呼吸窘迫综合征疗效观察[J].儿科药学杂志,2015,21(8):30-32.
[19]张均迈.肺表面活性物质联合布地奈德对急性脑损伤并发呼吸窘迫综合征患者脑血流的影响[J].实用临床医药杂志,2015,19(5):15-17,21.
[20]Ge MQ,Kokalari B,Flayer CH,et al.Cutting edge:role of NKcells and surfactant protein D in dendritic cell lymph node homing:effects of ozone exposure[J].J Immunol,2016,196(2):553-557.
[21]刘东成,劳庆禄,陆妹,等.早期气管内滴入以盐酸氨溴索作为载体的布地奈德预防早产儿慢性肺疾病[J].广东医学,2012,33(21):3327-3329.
[22]储晓彬,晏路标,韩树萍,等.肺表面活性物质联合布地奈德干预治疗对伴呼吸窘迫综合征的低出生体质量儿心功能的保护作用[J].实用儿科临床杂志,2012,27(14):1116-1118,1126.
[23]罗厚江,王静,谢怀珍,等.布地奈德联合氨溴索雾化吸入治疗新生儿吸入性肺炎疗效观察[J].蚌埠医学院学报,2012,37(1):48-50.
[2]王枫,乔艳梅,陈丽琴.持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的效果[J].中国妇幼保健,2017,32(13):2924-2927.
[3]黄列,徐锡,纪永佳,等.布地奈德联合固尔苏对支气管肺发育不良防治的研究[J].宁夏医学杂志,2017,39(6):511-512.
[4]王模奎,董文斌,黄薇,等.早期抢救性使用牛肺表面活性物质对早产儿严重呼吸窘迫综合征的疗效[J].儿科药学杂志,2017,23(6):12-15.
[5]余红蕾.经鼻持续气道正压通气对肺表面活性物质治疗新生儿呼吸窘迫综合征效果的影响[J].解放军医药杂志,2017,29(5):75-78.
[6]王红霞,徐心坦,张晓慧.不同时机应用经鼻持续气道正压通气联合肺表面活性物质治疗新生儿呼吸窘迫综合征的临床疗效观察[J].中国妇幼保健,2017,32(7):1565-1568.
[7]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质量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):137-141.
[8]吴杰斌,周彬,翟敬芳,等.不同无创通气模式联合肺表面活性物质在新生儿呼吸窘迫综合征初始呼吸支持的临床应用[J].中华临床医师杂志(电子版),2017,11(3):383-387.
[9]谭秀贞,吴时光,张建华,等.猪肺表面活性物质联合布地奈德混悬液气管内滴入治疗新生儿胎粪吸入综合征的疗效观察[J].中国当代儿科杂志,2016,18(12):1237-1241.
[10]Dagan MP,Hall SB.The equilibrium spreading tension of pulmonary surfactant[J].Langmuir,2015,31(48):13063-13067.
[11]陈奕江,张水堂,杨润娜.生后7天内气道内应用布地奈德对早产儿支气管肺发育不良发生率影响的系统评价和Meta分析[J].中国循证儿科杂志,2016,11(4):259-264.
[12]张媛柯,肖群文,李琪,等.早产儿支气管肺发育不良发生率及临床危险因素分析[J].中国新生儿科杂志,2016,31(3):198-200.
[13]柯华,李占魁,于西萍,等.不同剂型布地奈德联合肺表面活性物质治疗新生儿呼吸窘迫综合征疗效的比较[J].中国当代儿科杂志,2016,18(5):400-404.
[14]Lanka GK,Yu JJ,Gong S,et al.Ig A modulates respiratory dysfunction as a sequela to pulmonary chlamydial infection as neonates[J].Pathog Dis,2016,74(3):10-13.
[15]邓黎静.布地奈德联合肺泡表面活性物质气管内滴入治疗早产儿RDS的临床研究[D].衡阳:南华大学,2016.
[16]吴晨,邓春.支气管肺发育不良发病机制研究进展[J].儿科药学杂志,2016,22(4):57-60.
[17]林云,贾雁平,石霖,等.早产儿支气管肺发育不良防治研究[J].中国妇幼保健,2015,30(35):6246-6248.
[18]林云,贾雁平.布地奈德雾化吸入辅助治疗早产儿呼吸窘迫综合征疗效观察[J].儿科药学杂志,2015,21(8):30-32.
[19]张均迈.肺表面活性物质联合布地奈德对急性脑损伤并发呼吸窘迫综合征患者脑血流的影响[J].实用临床医药杂志,2015,19(5):15-17,21.
[20]Ge MQ,Kokalari B,Flayer CH,et al.Cutting edge:role of NKcells and surfactant protein D in dendritic cell lymph node homing:effects of ozone exposure[J].J Immunol,2016,196(2):553-557.
[21]刘东成,劳庆禄,陆妹,等.早期气管内滴入以盐酸氨溴索作为载体的布地奈德预防早产儿慢性肺疾病[J].广东医学,2012,33(21):3327-3329.
[22]储晓彬,晏路标,韩树萍,等.肺表面活性物质联合布地奈德干预治疗对伴呼吸窘迫综合征的低出生体质量儿心功能的保护作用[J].实用儿科临床杂志,2012,27(14):1116-1118,1126.
[23]罗厚江,王静,谢怀珍,等.布地奈德联合氨溴索雾化吸入治疗新生儿吸入性肺炎疗效观察[J].蚌埠医学院学报,2012,37(1):48-50.