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目的:观察布地奈德雾化吸入对新生儿呼吸机相关性喉头水肿的疗效。方法:将患有新生儿肺透明膜病或胎粪吸入综合征并接受气管插管时间≥72 h的新生儿158例,随机分为治疗组(83例)和对照组(75例)。对照组撤除气管内插管后予常规治疗,治疗组在此基础上予氧气驱动吸入布地奈德3次/d,每次0.5 mg,连续给药≥48 h。观察两组治疗有效率,治疗前后动脉血气指标变化和不良反应。结果:治疗组有效率为96.4%,高于对照组的有效率70.7%(P<0.01);拔管后12、24 h治疗组氧分压(PaO2)分别为(64.6±7.6)mmHg、(66.3±10.0)mmHg,氧饱和度(SpO2)分别为(93.0±2.7)%、(93.5±3.7)%,对照组拔管后12、24 h的PaO2分别为(56.1±5.9)mmHg、(57.6±7.1)mmHg,SpO2分别为(89.5±3.0)%、(90.1±3.8)%。治疗组的PaO2和SpO2均高于对照组(P均<0.05)。两组均无明显不良反应。结论:氧气驱动下雾化吸入布地奈德对新生儿呼吸机相关性喉头水肿安全有效。
OBJECTIVE: To observe the curative effect of budesonide inhalation on laryngeal edema associated with neonatal ventilator. Methods: 158 newborns with neonatal hyaline membrane disease or meconium aspiration syndrome and intubated intubation time≥72 h were randomly divided into treatment group (83 cases) and control group (75 cases). Control group after removal of endotracheal intubation routine treatment, the treatment group on the basis of oxygen inhalation of budesonide 3 times / d, each 0.5 mg, continuous administration of ≥ 48 h. Observation of two groups of treatment efficiency, arterial blood gas index changes and adverse reactions before and after treatment. Results: The effective rate of the treatment group was 96.4%, higher than that of the control group 70.7% (P <0.01); PaO2 of the treatment group was (64.6 ± 7.6) mmHg at 12 and 24 h after extubation 66.5 ± 10.0) mmHg and (93.0 ± 2.7)% (93.5 ± 3.7)% respectively in the control group and (56.1 ± 5.9) mmHg in the control group at 12 and 24 h after extubation ± 7.1) mmHg and SpO2 were (89.5 ± 3.0)% and (90.1 ± 3.8)%, respectively. PaO2 and SpO2 in the treatment group were higher than those in the control group (all P <0.05). No significant adverse reactions in both groups. Conclusions: Oxygen inhalation of budesonide is safe and effective for ventilator-associated laryngeal edema in neonates.