| 摘要: |
| 目的:探讨应用糖皮质激素治疗早期支气管肺发育不良(BPD)的疗效及安全性。方法:回顾性分析2016 年1 月至2019
年7 月入住我院,胎龄臆30 周且体质量臆1 500 g,生后28 d 不能撤离无创呼吸机和(或)脱氧的早期BPD 患儿住院资料。按使
用药物分为地塞米松(DXM)组24 例、氢化可的松(HC)组37 例及对照组50 例。对照组患儿早期接受咖啡因预防呼吸暂停、限
制液体量、呼吸支持、营养支持、存在感染时使用抗生素等常规治疗;HC 组在常规治疗基础上给予氢化可的松琥珀酸钠,疗程
10 d;DXM 组在常规治疗基础上给予地塞米松磷酸钠注射液,疗程9 d。比较三组患儿的围产期因素、治疗过程及临床结局情
况。结果:与对照组相比,DXM 组和HC 组患儿出生体质量较低,胎龄较小(P 均<0.05)。矫正胎龄36 周时,三组BPD 比例比
较差异无统计学意义(P 均>0.05),但DXM 组总用氧时间短于对照组和HC 组(P 均<0.05)。结论:使用DXM 或HC 治疗早期
BPD 不能有效降低矫正胎龄36 周时中重度BPD 的比例,但应用DXM 缩短了BPD 患儿的用氧时间。 |
| 关键词: 支气管肺发育不良 地塞米松 氢化可的松 早产儿 低出生体质量儿 |
| DOI：doi:10.13407/ j.cnki.jpp.1672.108X.2022.04.013 |
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| 基金项目: |
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| Application Value of Glucocorticoid in the Treatment of Early Bronchopulmonary Dysplasia |
| Affiliated Hospital of
Southwest Medical University, Sichuan Luzhou 646000, China |
| (He Yuan, Zhang Hongfei, Wang Xiaoling, Zhang Deshuang, Dong Wenbin, Lei Xiaoping) |
| Abstract: |
| Objective: To explore the efficacy and safety of glucocorticoid in the treatment of early bronchopulmonary dysplasia (BPD).
Methods: Clinical data of inpatients with early BPD admitted into our hospital from Jan. 2016 to Jul. 2019, gestational age 燮30 weeks
and body weight 燮1,500 g, who could not be withdraw from non鄄invasive ventilator and/ or deoxygenation at 28th day after birth were
retrospectively analyzed. All patients were divided into 24 cases in the dexamethasone (DXM) group, 37 cases in the hydrocortisone
(HC) group and 50 cases in the control group according to different treatment regimens. The control group received conventional
treatment such as caffeine for apnea prevention, fluid restriction, respiratory support, nutritional support and antibiotics for infection.
The HC group was given hydrocortisone sodium succinate on the basis of conventional treatment for 10 d. The DXM group was treated
with dexamethasone sodium phosphate injection on the basis of the conventional treatment for 9 d. The perinatal factors, treatment
process and clinical outcomes of three groups were compared. Results: Compared with the control group, the DXM group and HC group
had lower birth weight and smaller gestational age (P<0.05). At 36 weeks of postmenstrual age, there was no significant difference in
the proportion of BPD among three groups (P>0.05), yet the total oxygen consumption time in the DXM group was shorter than that in the control group and the HC group (P<0.05). Conclusion: Treatment of early BPD with DXM or HC was not effective in reducing the
rate of moderate to severe BPD at 36 weeks of postmenstrual age, yet application of DXM shortens the total oxygen consumption time in
children with BPD. |
| Key words: bronchopulmonary dysplasia dexamethasone hydrocortisone preterm infants low birth weight infants |
