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目的观察婴幼儿体外循环心脏直视术后吸入布地奈德对肺功能的影响。方法收治体外循环心脏直视手术患儿480例。随机分为布地奈德吸入组和对照组,每组240例。布地奈德吸入组术后吸入布地奈德混悬液(布地奈德0.5mg加9g/L盐水1.5mL),对照组吸入9g/L盐水(2.5～3.5mL),每3小时1次,12h后改为每8小时1次,疗程48h。测定各组术后1、2、3、4、5、6h潮气量、呼吸道压力、氧合指数、胸液指数,记录呼吸机通气及ICU监护时间。结果布地奈德吸入组术后1、2、3、4、5、6h潮气量、呼吸道压力、胸液指数、氧合指数均优于对照组(Pa<0.05);ICU监护时间及呼吸机通气时间少于对照组(Pa<0.05)。结论布地奈德吸入有利于婴幼儿心脏直视术后肺功能恢复,缩短呼吸机辅助通气时间及ICU监护时间。
Objective To observe the effect of inhaled budesonide on pulmonary function in infants with cardiopulmonary bypass. Methods 480 patients undergoing open heart surgery under cardiopulmonary bypass. Randomly divided into budesonide inhalation group and control group, 240 cases in each group. Budesonide inhalation group inhaled budesonide suspension (budesonide 0.5mg plus 9g / L saline 1.5mL), the control group inhaled 9g / L saline (2.5 ~ 3.5mL), once every 3 hours, 12h After the change to every 8 hours 1, treatment 48h. The tidal volume, airway pressure, oxygenation index, pleural fluid index, ventilator ventilation and ICU monitoring time were measured at 1, 2, 3, 4, 5 and 6 h after operation. Results The tidal volume, airway pressure, pleural fluid index and oxygenation index of budesonide inhalation group were better than those of control group (P <0.05) at 1, 2, 3, 4, Less time than the control group (Pa <0.05). Conclusions Budesonide inhalation is beneficial to the recovery of pulmonary function after direct cardiac surgery in infants and young children, shortening ventilator assisted ventilation time and ICU monitoring time.