| 摘要: |
| 目的：观察布地奈德联合维生素A为主的多种营养素防治新生儿支气管肺发育不良（BPD）的临床疗效。方法：选取2018年3月至2019年5月新生儿科重症监护室的120例早产儿，采用随机数字分组法分为对照组、布地奈德组和布地奈德+营养素组，对照组接受常规治疗，布地奈德组在常规治疗基础上加用布地奈德雾化吸入治疗，布地奈德+营养素组在常规治疗基础上加用布地奈德联合维生素A为主的多种营养素治疗，记录各组患儿吸氧时间、住院时间及住院期间BPD与其他常见并发症情况，观察治疗前后呼吸机相关参数[吸气峰压（PIP）、呼气末正压（PEEP）、吸入氧浓度（FiO2）、二氧化碳分压（PaCO2）、氧合指数（OI）]及白介素6（IL-6）和肿瘤坏死因子α（TNF-α）的变化。结果：布地奈德组和布地奈德+营养素组吸氧时间和住院时间短于对照组（P<0.05），且布地奈德组上述指标短于布地奈德+营养素组（P<0.05）；治疗后，三组PIP、PEEP、FiO2、IL-6及TNF-α均低于治疗前，OI和PaCO2均高于治疗前（P<0.05），其中布地奈德组和布地奈德+营养素组PIP、PEEP、FiO2、IL-6及TNF-α值均低于对照组，OI和PaCO2高于对照组，且布地奈德组改善程度优于布地奈德+营养素组（P<0.05）；治疗期间，对照组、布地奈德组及布地奈德+营养素组BPD发生率分别为35.00%（14/40）、17.50%和10.00%，其中布地奈德+营养素组BPD发生率明显低于对照组（P<0.05），但三组其他常见并发症发生率比较，差异无统计学意义（P>0.05）。结论：布地奈德联合维生素A为主的多种营养素可有效改善肺通气，降低早产儿BPD的发病率，且安全性较好。 |
| 关键词: 布地奈德 维生素A 早产儿 支气管肺发育不良 |
| DOI：10.13407/j.cnki.jpp.1672-108X.2021.02.009 |
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| 基金项目: |
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| Efficacy of Budesonide Combined with Multiple Nutrients in the Prevention of Bronchopulmonary Dysplasia in Premature Infants |
| Liu Gang, Kuang Ailing, Tan Wei, Huang Lingmin, Zhou Wenting |
| (Affiliated Hospital of Xiangnan University, Hunan Chenzhou 423000, China) |
| Abstract: |
| Objective: To observe the clinical efficacy of budesonide combined with vitamin A-based multiple nutrients in the prevention and treatment of premature infants with bronchopulmonary dysplasia (BPD). Methods: A total of 120 premature infants in the neonatal intensive care unit from Mar. 2018 to May 2019 were selected to be divided into the control group, the budesonide group and the budesonide + nutrient group via the random number table. The control group received conventional treatment, the budesonide group was treated with budesonide aerosol inhalation on the basis of the conventional treatment, and the budesonide + nutrient group was given budesonide combined with vitamin A-based multiple nutrients on the basis of conventional treatment. The duration of oxygen inhalation, length of stay, BPD and other common complications were recorded. Relevant parameters of the ventilator such as peak inspiratory pressure (PIP), positive end expiratory pressure (PEEP) and inhaled oxygen concentration (FiO2), blood gas index such as partial pressure of carbon dioxide (PaCO2), oxygenation index (OI), and changes in interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) before and after treatment were observed. Results: The duration of oxygen inhalation and length of stay in the budesonide group and the budesonide + nutrient group were shorter than those in the control group (P<0.05), and the above indexes in the budesonide + nutrient group were shorter than those in the budesonide group (P<0.05). After treatment, the values of PIP, PEEP, FiO2, IL-6 and TNF-α of three groups were lower than those before treatment, the values of OI and PaCO2 of three groups were higher than those before treatment (P<0.05). The values of PIP, PEEP, FiO2, IL-6 and TNF-α in the budesonide group and the budesonide + nutrient group were lower than those in the control group, and the improvement of OI and PaCO2 were higher than those in the control group, and the improvement in the budesonide + nutrient group was better than that in the budesonide group (P<0.05). During the treatment, the incidences of BPD in the control group, budesonide group and budesonide + nutrient group were respectively 35.00% (14/40), 17.50% and 10.00%, and the incidence of BPD in the budesonide + nutrient group was significantly lower than that in the control group (P<0.05), yet there was no statistical significance in the incidence of other common complications among three groups (P>0.05). Conclusion: Budesonide combined with vitamin A-based multiple nutrients can effectively improve the lung ventilation and reduce the incidence of BPD in premature infants with higher safety. |
| Key words: budesonide vitamin A premature infants bronchopulmonary dysplasia |
