Systematical Review of Budesonide Combined with Pulmonary Surfactant in the Treatment of Neonatal Respiratory Distress Syndrome

DONG Xuyan; CHEN Wenchao; CHENG Hongbin; LIU Li; DING Yueyin

doi:10.14009/j.issn.1672-2124.2022.02.023

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Systematical Review of Budesonide Combined with Pulmonary Surfactant in the Treatment of Neonatal Respiratory Distress Syndrome

更新时间：2022-10-08

- Systematical Review of Budesonide Combined with Pulmonary Surfactant in the Treatment of Neonatal Respiratory Distress Syndrome
- Vol. 22, Issue 2, Pages: 217-223(2022)
- 作者机构：
  
  鄂东医疗集团黄石市妇幼保健院/湖北理工学院附属医院(儿童医院)新生儿科
- 作者简介：
- 基金信息：
- DOI：10.14009/j.issn.1672-2124.2022.02.023
  CLC： R722.1
- Published：2022，
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DONG Xuyan, CHEN Wenchao, CHENG Hongbin, et al. Systematical Review of Budesonide Combined with Pulmonary Surfactant in the Treatment of Neonatal Respiratory Distress Syndrome. [J]. 22(2):217-223(2022)
DOI：

DONG Xuyan, CHEN Wenchao, CHENG Hongbin, et al. Systematical Review of Budesonide Combined with Pulmonary Surfactant in the Treatment of Neonatal Respiratory Distress Syndrome. [J]. 22(2):217-223(2022) DOI： 10.14009/j.issn.1672-2124.2022.02.023.

摘要

目的：系统评价布地奈德联合肺表面活性剂(PS)治疗新生儿呼吸窘迫综合征的临床疗效和安全性。方法：计算机检索中国知网、万方数据库、中国生物医学文献数据库、维普数据库、PubMed、Embase和the Cochrance Library等数据库，纳入布地奈德联合PS治疗新生儿呼吸窘迫综合征的随机对照研究(对照组患儿单纯使用PS治疗，研究组患儿使用布地奈德联合PS治疗)

提取符合纳入标准的文献并进行质量评价，运用RevMan 5.3软件进行Meta分析。结果：共纳入15篇文献，涉及1 317例患儿。Meta分析结果显示，研究组患儿的临床有效率(RR=1.25

95%CI=1.16～1.36)明显高于对照组，氧分压升高幅度(MD=8.02

95%CI=6.25～9.79)、二氧化碳分压降低幅度(MD=-5.72

95%CI=-6.70～-4.75)和氧指数降低幅度(MD=-2.61

95%CI=-2.97～-2.25)均明显优于对照组，呼吸机通气时间(MD=-1.50

95%CI=-1.79～-1.22)明显短于对照组，PS再次使用率(RR=0.31

95%CI=0.16～0.60)、中重度支气管肺发育不良发生率(RR=0.30

95%CI=0.22～0.43)明显低于对照组，上述差异均有统计学意义(P<0.05);所有患儿均未发生药品不良反应。Egger’s检验结果提示，无明显发表偏倚。结论：布地奈德联合PS可通过显著改善新生儿呼吸窘迫综合征患儿的呼吸窘迫体征、缩短呼吸机通气时间、减少PS再次使用和中重度支气管肺发育不良发生风险，从而提高近期临床疗效。

Abstract

OBJECTIVE: To systematically evaluate the the safety and efficacy of budesonide combined with pulmonary surfactant（PS） in the treatment of neonatal respiratory distress syndrome（NRDS）. METHODS: CNKI

Wanfang Data

CBM

VIP database

PubMed

Embase and the Cochrance Library were retrieved to collect the randomized controlled trial of budesonide combined with PS in the treatment of NRDS（the control group was treated with PS alone

while the study group received budesonide combined with PS）. Literature that met the inclusion criteria were extracted and quality evaluation was carried out. Meta-analysis was performed by using RevMan 5.3 software. RESULTS: A total of 15 related studies were enrolled

including 1 317 children. Meta-analysis results showed that the clinical effective rate（RR=1.25

95%CI=1.16-1.36） in the study group was significantly higher than that in the control group

and the increase in partial pressure of oxygen（MD=8.02

95%CI=6.25-9.79）

decrease in partial pressure of carbon dioxide（MD=-5.72

95%CI=-6.70--4.75） and decrease in oxygen index（MD=-2.61

95%CI=-2.97--2.25） were significantly better than those in the control group

ventilator ventilation time（MD=-1.50

95%CI=-1.79--1.22） was significantly shorter than the control group

PS re-use rate（RR=0.31

95%CI=0.16-0.60）

incidence of moderate to severe bronchopulmonary dysplasia（RR=0.30

95%CI=0.22-0.43） were significantly lower than those of the control group

and the above differences were statistically significant（P<0.05）. No adverse drug reactions were observed. Egger’s test showed no significant publication bias. CONCLUSIONS: Budesonide combined with PS can improve the short-term clinical efficacy through improving the respiratory distress of NRDS

shortening the respiratory ventilation time

decreasing the PS re-use rate and incidence of moderate to severe bronchopulmonary dysplasia.

关键词

新生儿呼吸窘迫综合征布地奈德肺表面活性剂Meta分析

Keywords

Neonatal respiratory distress syndromeBudesonidePulmonary surfactantMeta-analysis

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