目的 探究持续无创呼吸机辅助通气结合布地奈德和猪肺磷脂注射液治疗支气管肺发育不良低出生体重儿的临床疗效.方法 选取2013年6月至2016年6月期间安康市中心医院(北院区)新生儿科收治的96例合并新生儿呼吸窘迫综合征的低出生体重儿为研究对象,采用随机数表法将患儿分为A、B、C三组各32例.A组患儿给予持续无创呼吸机辅助通气治疗,B组患儿给予持续无创呼吸机辅助通气+猪肺磷脂注射液治疗,C组患儿给予持续无创呼吸机辅助通气+布地奈德+猪肺磷脂注射液治疗.比较三组患儿治疗后不同时间的pH值、二氧化碳分压(PaCO2)值,以及吸氧时间、住院天数和不良反应发生情况.结果 A、B、C三组患儿治疗第1天的pH值分别为(7.18±0.08)、(7.08±0.07)和(7.11±0.04),差异均无统计学意义(P>0.05);治疗第2～6天,三组患儿的pH值均先升高后降低,差异均具有统计学意义(P<0.05);A、B、C三组患儿治疗第1天的PaCO2值分别为(30.30±6.69)mmHg、(29.20±4.77)mmHg和(31.70±6.70)mmHg,差异无统计学意义(P>0.05);治疗第2～6天,三组患儿的PaCO2值均显著升高,B组与C组患儿的PaCO2值均高于A组,C组患儿的PaCO2值高于B组,差异均具有统计学意义(P<0.05);A、B、C三组患儿的总住院时间分别为(28.95±10.43)d、(26.43±9.03)d和(27.36±9.16)d,差异无统计学意义(P>0.05);A组患儿的辅助通气时间、高氧持续时间、总吸氧时间分别为(66.29±31.25)h、(4.33±1.72)h、(15.34±9.86)d,均显著高于B组和C组,B组患儿的辅助通气时间、高氧持续时间、总吸氧时间分别为(51.46±18.74)h、(2.96±1.12)h、(11.62±8.87)d,均高于C组患儿的(48.28±15.47)h、(2.22±0.95)h、(9.41±8.17)d,差异均具有统计学意义(P<0.05);三组患儿的各项不良反应发生率比较差异无统计学意义(P>0.05).结论 持续无创呼吸机辅助通气结合布地奈德和猪肺磷脂注射液能够有效治疗低出生体重儿支气管肺发育不良,且安全性较佳.%Objective To explore the clinical efficacy of continuous non-invasive ventilation combined with budesonide and poractant alfa injection in the treatment of bronchopulmonary dysplasia in low birth weight infants. Methods A total of 96 low birth weight infants with neonatal respiratory distress syndrome, who admitted to Depart-ment of Neonatology of the Central Hospital (North District) of Ankang City from June 2013 to June 2016, were se-lected and divided into A, B, C three groups according to random number table method, with 32 cases in each group. The A group哇was given continuous non-invasive ventilation treatment, the B group was given continuous non-inva-sive ventilation and poractant alfa injection, and the C group was given continuous non-invasive ventilation plus budesonide and poractant alfa injection. The pH value, partial pressure of carbon dioxide (PaCO2), oxygen uptake time, hospitalization days and adverse reactions were compared between the three groups at different times after the treatment. Results The pH values in the A, B and C group were respectively (7.18±0.08), (7.08±0.07) and (7.11±0.04) at the first day of treatment (P>0.05), and the values significantly increased and then decreased during day 2 to day 6 of treatment (P<0.05). The values of PaCO2 in A, B and C group were respectively (30.30 ± 6.69) mmHg, (29.20 ± 4.77) mmHg and (31.70 ± 6.70) mmHg at the first day of treatment (P>0.05), and the values in the three groups were signifi-cantly increased during day 2 to day 6 of treatment, which were significantly higher in B, C group than in A group and in C group that in B group (P<0.05). The hospitalization time of A, B and C group were respectively (28.95 ± 10.43) d, (26.43 ± 9.03) d and (27.36 ± 9.16) d (P>0.05). The auxiliary ventilation time, high oxygen duration, total oxygen uptake time in A group were (66.39±31.25) h, (4.33±1.72) h, (15.34±9.86) d, respectively, which were significantly longer than corresponding (51.42 ± 18.74) h, (2.96 ± 1.12) h, (11.62 ± 8.87) d in B group and (48.28 ± 15.47) h, (2.22 ± 0.95) h (9.41 ±8.17) d in C group (P<0.05). There was no significant difference in the incidence of adverse reactions between the three groups (P>0.05). Conclusion Continuous non-invasive ventilation combined with budesonide and poractant alfa injec-tion can effectively treat low birth weight children with bronchopulmonary dysplasia, with better safety.
展开▼
