Clinical Observation Of Intratracheal Instillation Of Ke Li Su Combined With Budesonide To Prevent Bronchopulmonary Dysplasia In Very Low Birth Weight Infants

Objective To explore the clinical effect of intratracheal instillation of pulmonary surfactant(Ke Li Su)combined with Budesonide to prevent bronchopulmonary dysplasia(BPD)in very low birth weight infants.So as to provide clinical evidence for prevent bronchopulmonary dysplasia in very low birth weight infants.Methods A total of 30 very low birth weight premature infants with gestational age<32 weeks who developed neonatal respiratory distress syndrome(NRDS)(grade III-IV)suffering from inflammation and infection were randomly assigned into the PS +budesonide group and PS group.The results of comparison include the birth weight,gestational age,sex,birth weight,cesarean section,apgar scores and the use of prenatal corticosteroids.The changes were compared between the two groups in vital signs(including respiration,heart rate,blood pressure,transcutaneous oxygen saturation)before and after treatment,arterial blood gas analysis(including value of pH,arterial oxygen tension and the partial pressure of carbon dioxide),oxygenation index(OI),oxygen concentration,duration of mechanical ventilation,duration of oxygen supplementation,the incidence of BPD,the mortality rate at 36 weeks’ postmenstrualage and other complications(such as hyperglycaemia,hypertension,pneumothorax,patent ductus arteriosus,intracranial hemorrhage,necrotizing enterocolitis and so on).Results (1)There were no significant differences in the birth weight,gestational age,sex,birth weight,cesarean section,apgar scores and the use of prenatal corticosteroids among the two groups(P > 0.05);(2)Significant differences were not found betweenthe two grups with regard to the vital signs(including respiration,heart rate,blood pressure,transcutaneous oxygen saturation)before and after treatment in different time(P > 0.05);(3)Before treatment and on the first day after treatment,the arterial blood gas analysis(including value of pH,arterial oxygen tension and the partial pressure of carbon dioxide),oxygenation index(OI),oxygen concentration have no statistically significant among the two groups(P>0.05);On the 2nd to 6th day after treatment,the PS+budesonide group had higher pH value of arterial blood gas and OI and lower carbon dioxide partial pressure(P<0.05)and lower oxygen concentrationthe,the arterial oxygen tension have no statistically significant among the two groups(P>0.05);(4)Compared with the PS group,PS+budesonide group had a lower incidence of bronchopulmonary dysplasia,shorter duration of mechanical ventilation and oxygen supplementation(P<0.05);(5)There showed no difference between the two groups in mortality rate at 36 weeks’ postconceptional and other complications(P>0.05).Conclusion Compared with the PS group,intratracheal instillation of PS combined with budesonide can effectively improve ventilation function and significantly reduce the incidence of BPD in very low birth weight premature infants with severe respiratory distress syndrome,there were no significant differences in mortality rate and other complications.