Clinical Study Of PS Combined With Budesonide Endotracheal Instillation For Prevention Of BPD In Preterm Infants

Objective:To reduce the incidence of bronchopulmonary dysplasia in preterm infants and to improve the quality of life of premature infants,pulmonary surfactant was used in combination with intratracheal instillation of budesonide in order to achieve early evacuation of the ventilator and oxygen deprivation.Methods : Thirty-eight premature infants with RDS were collected in our study :Selected from March 2015-March 2017 birth of the hospital born weight <1.5Kg,gestational age ≤ 32 weeks,there are respiratory distress syndrome(respiratory distress syndrome,RDS),need mechanical ventilation in 38 cases of premature children,Of the congenital malformations,children’s family agreed to sign,and signed informed consent,the hospital was randomly divided into PS + budesonide group(n=18)and PS group(n=20).There was no statistically significant difference in birth weight,gestational age,sex,mode of delivery,Apgar score,prenatal hormone and PS dosage,and budesonide dosage.PS + budesonide group using PS and budesonide mixture(0.25 mg budesonide per 70 mg of PS),PS dose 70 mg / kg,budesonide 0.25 mg / kg.PS group using a single PS,dose 70 mg / kg.Blood glucose analysis,oxygenation index,1 day,2days,3 days,4 days,5 days and 6 days after the administration of blood gas were measured before and after the administration of the two groups.(IL6,IL8,TNF-α),mechanical ventilation time,total oxygen time,length of hospital stay,BPD incidence and other related adverse events(P <0.05)Response:nosocomial infection,hypertension,hyperglycemia,gastrointestinal bleeding,neonatal necrotizing enterocolitis(Neonatal necrotizing enterocolitis)and so on.Results:PS group and PS + budesonide group before and after treatment 1,2,3,4,5,6 days PH value,the difference was statistically significant(P <0.05).PS group and PS+ budesonide group before and after treatment 1,2,3,4,5,6 days Pa O2,the difference was statistically significant(P <0.05).PS group and PS + budesonide group before and after treatment 1,2,3,4,5,6 days Pa CO2,the difference was statistically significant(P<0.05).PS group and PS + budesonide group before and after treatment 1,2,3,4,5,6days OI,the difference was statistically significant(P <0.05).There was significant difference between the PS group and the PS + budesonide group and the peripheral blood cytokines(TNF-α,IL-6 and IL-8)before and 5 days after treatment.The difference was statistically significant(P <0.05).PS and PS + budesonide group children with mechanical ventilation time,total oxygen time and hospitalization days,the difference was statistically significant(P < 0.05).PS and PS + budesonide group children compare the incidence of adverse reactions,there was no statistically significant difference(P > 0.05).Conclusion:(1)RDS premature infants,tracheal infusion of pulmonary surfactant(PS)and budesonide mixture,can effectively reduce the inflammatory response,reduce the incidence of BPD.(2)Relying on PS as a carrier combined with budesonide,can effectively reduce the children’s mechanical ventilation time and total oxygen time.