| Objective:(1)To explore whether budesonide combined with pulmonary surface active substances can reduce the incidence and severity of bronchopulmonary dysplasia(BPD)in premature infants.(2)To analyze the risk factors of BPD in premature infants(gestational age ≤32 weeks or weight ≤1500g),and to provide clinical basis for the prevention and treatment of BPD.Method:(1)A total of 70 cases of premature infants who met the inclusion criteria in our hospital from January 2019 to December 2020 were selected and divided into experimental group and control group according to the order of admission,with 35 cases in each group.In the experimental group,a mixture of pulmonary Surfactant(PS)and budesonide was injected intratracheal.The control group only received PS endotracheal aspiration.To analyze the improvement of blood gas indexes(p H value,Pa CO2,Pa O2 and Pa O2/Fi O2)and positive end-expiratory pressure before and after administration in the two groups.To compare the incidence,severity and incidence of complications of BPD between the two groups.(2)Select the experiment in 70 cases of children with basic data(birth weight and gestational age,gender,whether multiplets,delivery methods,Apgar1 minutes score,with or without premature rupture of membranes,pregnant mother of disease during pregnancy and prenatal application hormone,etc.),the length of the treatment in the process of mechanical ventilation(whether,blood transfusion,etc.)and its complications,in accordance with BPD occur as the condition,divided into BPD group(18 cases)and non BPD group(52 cases),through the correlation regression analysis the risk factors of BPD.Results:(1)There was no statistical difference between the two groups in the general information of children and pregnant mothers(P>0.05).After treatment,the p H value,Pa O2 and Pa O2/Fi O2 in the experimental group were significantly improved compared with the control group,and Pa CO2 in the experimental group decreased more significantly(P < 0.05).After treatment,the positive end expiratory pressure of the experimental group was improved more significantly than that of the control group(P <0.05).The duration of ventilator use,oxygen inhalation and hospital stay in the experimental group were significantly shorter than those in the control group(P <0.05).The incidence of BPD in the experimental group and the control group was14.29% and 37.14%,with statistically significant difference between the two groups(P< 0.05).There was no significant difference in the severity of the disease between the two groups(P>0.05).There was no statistically significant difference in the incidence of complications between the experimental group and the control group(P > 0.05).The reutilization rate of PS in the experimental group was lower than that in the control group(P < 0.05).(2)The analysis of BPD-related risk factors in the two groups of preterm infants showed that PDA(OR: 6.282,95%CI: 1.325-29.791),Apgar 1min score≤3(OR: 3.235,95%CI: 1.065-9.824),amniotic fluid pollution(OR: 10.909,95%CI: 2.271-52.412),premature rupture of membranes(OR: 4.413,95%CI: 1.279-15.229),mechanical ventilation(OR: 9.333,95%CI: 1.946-44.765)and transfusion ≥3 times(OR: 3.876,95%CI: 1.263-11.899)were independent risk factors for BPD.Conclusions:(1)Budesonide combined with PS endotracheal injection significantly reduced the risk of BPD in preterm infants without increasing the incidence of other complications.(2)Risk factors for BPD in premature infants include: Apgar 1min score≤3,abnormal amniotic fluid,mechanical ventilation,premature rupture of membranes,frequency of blood transfusion ≥3 times,combined with PDA. |
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