[1]丁晓燕.布地奈德联合持续正压通气治疗新生儿呼吸窘迫综合征疗效研究[J].陕西医学杂志,2022,51(5):599-603.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.020]
　DING Xiaoyan.Efficacy of budesonide combined with continuous positive pressure ventilation in treatment of neonatal respiratory distress syndrome[J].,2022,51(5):599-603.[doi:DOI:10.3969/j.issn.1000-7377.2022.05.020]
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布地奈德联合持续正压通气治疗新生儿呼吸窘迫综合征疗效研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
51
期数:
2022年5期
页码:
599-603
栏目:
药物与临床
出版日期:
2022-05-05

文章信息/Info

Title:
Efficacy of budesonide combined with continuous positive pressure ventilation in treatment of neonatal respiratory distress syndrome
作者:
丁晓燕
(丹阳市妇幼保健院,江苏 丹阳 212300)
Author(s):
DING Xiaoyan
(Danyang Maternal and Child Health Hospital,Danyang 212300,China)
关键词:
新生儿呼吸窘迫综合征;  治疗;  布地奈德;  持续正压通气;  血气指标;  炎性因子
Keywords:
Neonatal respiratory distress syndrome;  Therapy;  Budesonide;  Continuous positive pressure ventilation;  Blood gas index;  Inflammatory factor
分类号:
R 722.19
DOI:
DOI:10.3969/j.issn.1000-7377.2022.05.020
文献标志码:
A
摘要:
目的:探讨布地奈德联合持续正压通气治疗新生儿呼吸窘迫综合征的有效性和安全性。方法:选取新生儿呼吸窘迫综合征患儿88例,以随机数字表法分成对照组和观察组,每组各44例。对照组患儿常规治疗结合持续正压通气治疗,观察组患儿在对照组治疗的基础上再以布地奈德雾化吸入治疗,观察两组患儿治疗前后的治疗效果、血气指标、炎性因子水平及氧疗时间、正压通气时间、住院时间。结果:观察组患儿治疗总有效率(93.18%)明显高于对照组患儿治疗总有效率(75.00%)(P<0.05); 治疗前,两组患儿动脉血氧饱和度(SaO2)、二氧化碳分压(PaCO2)、血氧分压(PaO2)指标对比差异无统计学意义(P>0.05); 治疗后,两组患儿SaO2、PaCO2、PaO2指标对比差异有统计学意义(均P<0.05); 较治疗前,治疗后两组患儿SaO2、PaO2指标水平均明显升高,PaCO2指标水平均降低(均P<0.05); 治疗前,两组患儿炎性因子白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平比较差异无统计学意义(P>0.05); 治疗后,两组患儿的炎性因子IL-6、TNF-α水平均与治疗前比较降低(均P<0.05); 治疗后,观察组患儿的炎性因子IL-6、TNF-α水平明显低于对照组(均P<0.05); 观察组患儿住院费用、住院时间、正压通气时间、氧疗时间明显少于对照组(均P<0.05); 治疗后,观察组患儿并发症的总发生率(15.91%)明显低于对照组(2.27%)(P<0.05)。结论:布地奈德联合持续正压通气治疗新生儿呼吸窘迫综合征效果显著,能明显缩短患儿住院时间和正压通气时间,减轻患儿家庭的医疗负担,并降低其炎性因子水平,同时也能改善其血气指标、降低并发症的发生率、安全可靠。
Abstract:
Objective:To investigate the efficacy and safety of budesonide combined with continuous positive pressure ventilation in the treatment of neonatal respiratory distress syndrome.Methods: A total of 88 infants with neonatal respiratory distress syndrome were selected and randomly divided into control group and observation group,with 44 cases in each group.The children in control group were treated with conventional treatment combined with continuous positive pressure ventilation.The children in observation group were treated with budesonide nebulized inhalation on the basis of control group.The therapeutic effect,blood gas indexes,inflammatory factor levels,oxygen therapy time,positive pressure ventilation time and hospitalization time of the two groups were observed before and after treatment.Results:The total effective rate in observation group was significantly higher than that in control group(93.18% vs.75.00%,P<0.05).Before treatment,there was no significant difference in arterial oxygen saturation(SaO2),partial pressure of carbon dioxide(PaCO2)and partial pressure of blood oxygen(PaO2)between the two groups(all P>0.05).After treatment,there were significant differences in SaO2,PaCO2 and PaO2 between the two groups(all P<0.05).Compared with before treatment,the levels of SaO2 and PaO2 in both groups were significantly increased,and PaCO2 decreased after treatment(all P<0.05).here was no significant difference in the levels of inflammatory cytokines interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)between the two groups(all P>0.05).After treatment,the levels of IL-6 and TNF-α in the two groups were lower than those before treatment,and the levels of and TNF-α in observation group were significantly lower than those in ontrol group(all P<0.05).The hospitalization cost,hospitalization time,positive pressure ventilation time and oxygen therapy time in bservation group were significantly lower than those in ontrol group(all P<0.05).After treatment,the total incidence of complications of observation group was significantly lower than that of control group(15.91% vs.2.27%,P<0.05).Conclusion:The combination of budesonide and continuous positive pressure ventilation in the treatment of NRDS has a significant effect,which can significantly shorten the hospitalization time and positive pressure ventilation time of the children,reduce the medical burden of the children's family,reduce the level of inflammation,and also improve the blood gas indexes,reduce the incidence of complications,and is safe and reliable.

参考文献/References:

[1] 曹 云.极早/超早产儿救治及预后:从提高存活率到关注生存质量[J].中华围产医学杂志,2018,21(6):367-375.
[2] 张艳波.NRDS与早产儿体内游离肉碱水平的相关研究进展[J].国际儿科学杂志,2019,46(4):259-262.
[3] 翁晓文,刘 畅,孙俏丽,等.滨海县人民医院2008-2015年住院新生儿死亡原因分析[J].现代医学,2017,45(9):1295-1298.
[4] 吴 晨,邓 春.新生儿呼吸窘迫征并发支气管肺发育不良的高危因素[J].重庆医科大学学报,2017,42(8): 1016-1022.
[5] 林 蔷,黎巧茹,陈 简.不同剂量肺表面活性物质对晚期早产/足月新生儿呼吸窘迫综合征患儿的临床研究[J].中国临床药理学杂志,2020,36(6):610-612.
[6] Emeriaud G,Napolitano N,Polikoff L,et al.Impact of failure of noninvasive ventilation on the safety of pediatric tracheal intubation[J].Critical Care Medicine,2020,48(10):1503-1512.
[7] Kasat K,Patel H,Predtechenska O,et al.Anti-inflammatory actions of endogenous and exogenous interleukin-10 versus glucocorticoids on macrophage functions of the newly born[J].Journal of Perinatology Official Journal of the California Perinatal Association,2014,34(5):380-385.
[8] 虎琼华,崔 巍,张 鸣,等.乌司他丁联合地塞米松治疗急性呼吸窘迫综合征的疗效观察[J].现代药物与临床,2018,33(3):528-531.
[9] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].北京:人民卫生出版社,2011.
[10] 王立云,郝 丽,陶名玉,等.HFOV联合PS对治疗新生儿ALI/ARDS的疗效及对肺动态顺应性的影响[J].现代生物医学进展,2021,21(17):3325-3330.
[11] 曹 洁.无创正压通气的临床应用[J].临床内科杂志 2009,26(7):444-447.
[12] 赵金章,刘 玲,张 莉,等.无创高频振荡通气与经鼻持续气道正压通气在新生儿呼吸窘迫综合征初始治疗中的疗效评价[J].陕西医学杂志,2019,48(11):1461-1463,1467.
[13] Sinha P,Calfee CS,Cherian S,et al.Prevalence of phenotypes of acute respiratory distress syndrome in critically ill patients with COVID-19:A prospective observational study[J].Lancet Respiratory Medicine,2020,8(12):1209-1218.
[14] 于宗君,王广俊.定喘汤联合布地奈德雾化吸入治疗小儿毛细支气管炎对其免疫功能及炎症因子水平的影响[J].环球中医药,2018,11(7):142-144.
[15] 黄传君,张永莲,陈方方,等.布地奈德对支气管哮喘小鼠气道重塑及其相关炎性介质表达的影响[J].中华结核和呼吸杂志,2017,40(3):231-233.
[16] 魏 欣,董占军,吴 茵.鼻用类固醇皮质激素的药理及其临床应用进展[J].中国药房,2008,32(29):2302-2304.
[17] 王 君,王建民,崔福英,等.不同布地奈德给药方式联合PS对呼吸窘迫综合征患儿肺功能及安全性的影响[J].国际呼吸杂志,2019,39(15):1163-1168.
[18] 母群华.无创呼吸机正压通气联合布地奈德雾化吸入治疗重症哮喘的临床效果观察[J].临床合理用药杂志,2019,12(11):44-45.
[19] Tsu F,Chen CM,Shou Y,et al.Intratracheal administration of budesonide/surfactant to prevent bronchopulmonary dysplasia[J].American Journal of Respiratory and Critical Care Medicine,2016,193(1):86-95.
[20] 毛晓惠.布地奈德联合猪肺磷脂注射液治疗重度新生儿呼吸窘迫综合征效果观察[J].山西医药杂志,2020,49(14):1796-1798.
[21] 郭 梅,王 卫.布地奈德雾化吸入对小儿哮喘患者外周血炎症因子及肺功能的影响[J].河北医学,2017,39(7):34-38.
[22] 马秀红.无创呼吸机正压通气联合布地奈德混悬液雾化吸入治疗45例重症支气管哮喘患者的回顾性研究[J].山西医药杂志,2018,47(10):1179-1181.
[23] 魏小娣,樊 婷.经鼻持续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临床观察[J].解放军医药杂志,2017,29(11):61-64.

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更新日期/Last Update: 2022-05-05