Comparison Of The Efficacy Of Different Ventilation Modes And Pharmacological Interventions For The Prevention Of Bronchopulmonary Dysplasia In Preterm Infants

Objective:To study the effects of constant frequency mechanical ventilation mode（CMV）,high frequency oscillatory ventilation mode（HFO）,pulmonary surfactant（PS）and budesonide（Budesonide,BUD）on the treatment index of neonatal respiratory distress（RDS）and the occurrence of bronchopulmonary dysplasia（BPD）,to explore the effects of different mechanical ventilation patterns and drug intervention on bronchopulmonary dysplasia in premature infants.Methods:120 premature infants with less than 32 weeks gestational age,birth weight less than 2000g and diagnosed with RDS within 8 hours of birth were randomly divided into four groups,30 cases in each group:Group 1（G1）used ventilator CMV mode and alveolar surfactant alone;Group 2（G 2）,using the ventilator high-frequency mode（HFO）,With the alveolar surfactant alone;Group 3（G 3）was in the ventilator CMV mode,The combination of alveolar surfactant with BUD,Group 4（G 4）uses the ventilator high-frequency mode（HFO）,Alveolar surfactant was combined with BUD.Changes in arterial blood gas,duration of invasive mechanical ventilation,total oxygen inhalation,incidence of reuse PS,BPD and adverse effects were compared in the four groups.Results:（1）Changes in blood gas analysis.Compared with before treatment,the PH value of G4 group was higher than that G3 group at 72 hours after treatment（P<0.05）.quadruplet PCO₂There was no significant difference（P>0.05）;PO₂The improvement at each time was 48h,72h,Higher in G4 than in G1,G2,G3,P<0.05;（2）Comparison of invasive mechanical ventilation time and total oxygen inhalation time between the four groups:comparison of ventilator time between the four groups G1>G2>G3>G4,G4 group is less than G1,G2,G3 group,Statistically significant difference（P<0.05）,The G4 group ventilator has a shorter use time;Total oxygen time The G4 group had an average oxygen time of 23 days,Shorter as compared to the remaining groups,However,there was no significant difference in total oxygen time in the four groups（P>0.05）.（3）the difference of BPD in the four groups,G4 was less than the other three groups,P<0.05;（4）the difference of repeated PS in G1 and G3 than G2 and G4（P<0.05）;no difference in adverse reactions in the four groups（P>0.05）.Conclusion:（1）PS and BUD for RDS in HFO mode are effective in improving oxygenation and have short ventilator time.（2）The incidence of BPD was less than PS plus BUD than the other three groups;（3）Using PS and BUD in HFO mode has a good effect in treating RDS,which can obviously prevent BPD.