Application Value of Budesonide Combined with Endotracheal Intubation, Active Substances on the Lung Surface, Extubation and Continuous Positive Airway Pressure Ventilation in Premature Infants with Respiratory Distress Syndrome
ZHU Xi-yi, LI Liu-qing, LI Fu-bing,et al
Department of Pediatrics, the People's Hospital of Guangxi Zhuang Autonomous Regin, Nanning 530021, China
Abstract：【Objective】To explore the use of Application value of budesonide combined with endotracheal intubation, active substances on the lung surface, extubation and continuous positive airway pressure ventilation in premature infants with respiratory distress syndrome. 【Methods】The clinical data of 30 premature infants with NRDS treated in our hospital from January 2018 to December 2019 were retrospectively analyzed. According to different treatment methods, they were divided into observation group and control group, with 15 cases in each group. Both groups were treated with insert technology, and the observation group was treated with budesonide. The blood gas analysis indexes, PS reuse rate, average weaning time, average total oxygen inhalation time, incidence and severity of BPD were compared between the two groups, and the complications during treatment were recorded and compared between the two groups. 【Results】 At 12 h and 24 h after administration, the levels of ph and PaCO2 in the two groups were higher than those at 4 h after administration, and those in the observation group were higher than those in the control group; The level of PaCO2 in the two groups was lower than 4 hours after administration, and the level of PaCO2 in the observation group was lower than that in the control group(mean P<0.05). The reuse rate of PS, the incidence of BPD and the proportion of moderate to severe BPD in the observation group were lower than those in the control group(P<0.05). After CPAP treatment, the average withdrawal time and average total oxygen inhalation time in the observation group were lower than those in the control group(P<0.05). There was no significant difference in the incidence of retinopathy, late-onset sepsis, necrotizing enterocolitis and periventricular intraventricular hemorrhage between the two groups(P>0.05).【Conclusion】Budesonide combined with insert technology in the treatment of respiratory distress syndrome of preterm infants can effectively improve the blood gas index of children, improve the treatment effect, reduce the occurrence of BPD in preterm infants, and do not increase the risk of complications during treatment. It is worthy of popularization and application.
朱曦怡, 李柳青, 李福兵, 谢钰雁, 韦秀珍. 布地奈德联合气管插管-肺表面活性物质-拔管使用持续气道正压通气技术在早产儿呼吸窘迫综合征的应用价值[J]. 医学临床研究, 2021, 38(7): 975-977.
ZHU Xi-yi, LI Liu-qing, LI Fu-bing,et al. Application Value of Budesonide Combined with Endotracheal Intubation, Active Substances on the Lung Surface, Extubation and Continuous Positive Airway Pressure Ventilation in Premature Infants with Respiratory Distress Syndrome. JOURNAL OF CLINICAL RESEARCH, 2021, 38(7): 975-977.
[1] SWEET D.European consensus guidelines on the management of neonatal respiratiory distress syndrome[J].J Perinat Med,2007,35(3):175-186. [2] ELMEKKAWI A.Use of naloxone to minimize extubation failure after premedication for INSURE procedure in preterm neonates[J].J Neonatal Perinatal Med,2016,9(4):363-370. [3] 王刚,高敏 INSURE技术治疗早产儿呼吸窘迫综合征临床观察[J].中国临床新医学,2017,10(10):978-981. [4] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].第4版.北京:人民卫生出版社,2011:416-417. [5] 丁悦,唐丽君,黄为民.早产儿支气管肺发育不良的诊治新进展[J].实用儿科临床杂志,2012,27(2):141-146. [6] SWEET D G.European consensus guidelines on the management of neonatal respiratiory distress syndrome-2019 update[J].Neonatology,2019,115(4):432-450. [7] 王林涛,张丙宏.糖皮质激素的两种给药方案对NRDS疗效的影响[J].中国妇幼健康研究,2017,28(10):1205-1208. [8] 蔡志勇,刘进娣,卞洪亮,等.不同时间应用“气管插管-使用肺表面活性物质-拔管使用持续呼吸道正压通气”技术在呼吸窘迫综合征高危早产儿中的疗效[J].中华实用儿科临床杂志,2016,31(2):101-104. [9] JOBE A H, Bancalari E. Bronchopulmonary dysplasia [J].Am J Respir Crit Care Med,2001,163(7):1723-1729. [10] DOYLE W.Dexamethasone treament in the frist week of life for bronchopulmonary dysplasis in preterm infants[J].Neonatology,2010,98(4):289-296. [11] THOMAS W,SPEER C P.Management of infants with bronchopulmonary dysplasis in Germany[J].Early Hum Dev,2005,81(2):155-163. [12] BASSLER D,HALLIDAY H L,PLAVKA R,et al.The Neonatal European Study of inhaled Steroids(NEUROSIS):an eu-funded international randomised controlled trial in preterm infants[J].Neonatalogy,2010,97(1):52-55. [13] TSU F Y,CHUNG M C,SHOU Y W,et al.Intra-tracheal Administration of Budesonide/Surfactant to prevent BPD[J].Am J Respir Crit Care Med,2016,193(1):86-95.
2021, Vol. 38 
