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目的:观察雾化吸入布地奈德混悬液治疗新生儿机械通气拔管后喉头水肿的疗效。方法:88例接受气管插管行机械通气的新生儿随机分为两组,治疗组43例,拔管前30min应用吸入用布地奈德混悬液0.5mg+0.9%生理盐水2mL雾化吸入1次,拔管后1次/h,共3次;对照组45例,拔管前1h静脉注射地塞米松0.5mg/kg,拔管后每1小时雾化吸入异丙肾上腺素0.25mg+0.9%生理盐水2mL,共3次。两组均监测心率(HR)、呼吸(RR)及经皮监测血氧饱和度(SpO2),并予以吸氧、吸痰、抗感染等综合对症处理。结果:治疗组喉头水肿症状持续时间比对照组短,两组比较,差异有显著性(P<0.01);雾化后1h治疗组(PaO2)比对照组高,两组比较,差异有显著性(P<0.01);治疗组二氧化碳分压(PaCO2)、RR均比对照组低,两组比较,差异有显著性(P<0.01)。结论:雾化吸入布地奈德混悬液可以快速、有效地减轻新生儿机械通气拔管后喉头水肿,副作用小,值得临床推广应用。
Objective: To observe the effect of inhalation of budesonide suspension on laryngeal edema after mechanical ventilation extubation in neonates. Methods: Eighty-eight neonates undergoing mechanical ventilation with endotracheal intubation were randomly divided into two groups. The treatment group (n = 43) received inhalation of budesonide suspension 0.5 mg + 0.9% saline 2 mL inhalation 30 min before extubation Times, extubation 1 times / h, a total of 3 times; control group of 45 cases, 1h before extubation dexamethasone 0.5mg / kg intravenous injection of isoproterenol 0.25mg + 0.9 % Saline 2mL, a total of 3 times. The two groups were monitored heart rate (HR), respiration (RR) and percutaneous oxygen saturation (SpO2), and to be oxygen, suction, anti-infective and other comprehensive symptomatic treatment. Results: The duration of laryngeal edema in the treatment group was shorter than that in the control group. There was significant difference between the two groups (P <0.01). PaO2 in the treatment group was higher than that in the control group at 1 hour after nebulization. There was significant difference between the two groups (P <0.01). The PaCO2 and RR of the treatment group were lower than those of the control group. There was significant difference between the two groups (P <0.01). Conclusion: Inhalation of budesonide suspension can quickly and effectively reduce laryngeal edema after mechanical ventilation in extubation. The side effect is worthy of clinical application.