【摘要】 目的观察雾化吸入布地奈德对治疗超早早产儿（出生胎龄<28周）支气管肺发育不良（Bronchopulmona-ry Dysplasia,BPD）效果。方法超早早产儿46例随机分为治疗组20例及对照组26例。治疗组从出生第28天采用布地奈德0.5 mg雾化吸入治疗,每日2次,共治疗10天;对照组在治疗过程中不使用布地奈德,亦不使用其他类型糖皮质激素。分别于出生28、38天记录两组患儿呼吸机参数[吸气峰压（peak inspiratory pressure,PIP）、平均气道压（mean airway pressure,MAP）、吸氧浓度（fraction of inspired oxygen,FiO₂）、动脉血二氧化碳分压（pressure of carbon di-oxide,PCO₂）],记录两组患儿治疗后机械通气时间、用氧时间、住院时间,判断治疗效果,纠正胎龄36周对两组患儿进行BPD分度,记录治疗过程中不良反应发生情况。结果与对照组比较,出生第38天时治疗组PIP、MAP、FiO₂、PCO₂低（P均<0.05）。与对照组比较,治疗组机械通气时间、用氧时间及住院时间短（P均<0.05）。治疗组BPD分度为轻度8例、中度9例、重度3例,对照组分别为3、12、11例,与对照组比较,治疗组BPD分度轻度患者比例大,重度比例小（P<0.05）。两组患儿不良反应发生率差异无统计学意义。纠正胎龄36周及6月时两组患儿平均体质量、身高、头围及格塞尔评分差异无统计学意义。结论雾化吸入布地奈德治疗超早早产儿BPD效果较好,可明显降低患儿呼吸机参数,缩短机械通气时间及用氧时间,降低重度BPD比例,且安全性较好。更多还原

【Abstract】 Objective pulmonary dysplasia（BPD）in extremely premature infants（with gestational age at birth of less than 28 weeks）.Methods group of 20 cases and control group of 26 cases. The infants of inhalation group were treated with aerosol inhalation of 0. 5 mg budesonide,from the 28th day after birth,twice a day,for 10 days. The infants of the control group were not treated with budesonide or other types of glucocorticoids. Then the ventilator parameters of both on the 28th day and the 38th day after birth were compared between the two groups,including peak inspiratory pressure（PIP）,mean airway pressure（MAP）,fraction of inspired oxygen（FiO₂）,and arterial partial pressure of carbon dioxide（PCO₂）. The duration of ventilation time,inhale oxygen time and hospitalization time were compared between the two groups to determine the treatment effects. The severity of BPD and adverse reactions were also compared between the two groups at the postmenstrual age of 36 weeks.Results lower than those of the control group,including PIP,MAP,FiO₂ and PCO₂（all P<0. 05）. There were 8 mild BPD cases,9 moderate BPD cases and 3 severe BPD cases in the inhalation group,while there were 3,12 and 11 cases in the control group. Compared with the control group,the proportion of mild BPD cases was higher and the proportion of severe cases was lower in the inhalation group（all P<0. 05）. There was no statistically significant difference in the incidence of adverse reactions between the two groups（P>0. 05）. The follow-up results of body weight,body length,head circumference and Gesell scores showed no statistically difference between the two groups at the postmenstrual age of 36 weeks and 6 months（all P>0. 05）.Conclusion shorten the duration of ventilator time and oxygen supply time,reduce the proportion of infants with severe BPD,and meanwhile,it has good security.更多还原