肝素钠辅助治疗新生儿持续肺动脉高压

Hepar in Sodium Adjuvant Treatment of Persistent Pulmonary Hypertension of the Newborn

目的:结合临床病例,分析与探讨肝素钠在治疗新生儿持续肺动脉高压的作用及其可能机制,为新生儿持续肺动脉高压新的辅助药物治疗及联合治疗提供新的思路。方法:观察和分析2019年7月-2020年10月在石河子大学医学院第一附属医院住院并采用肝素钠辅助治疗新生儿持续肺动脉高压病例5例,探讨肝素钠在新生儿持续肺动脉高压辅助治疗中可能的作用。结果:早产儿2例,足月儿3例;顺产2例,剖宫产3例;有出生窒息3例,1例母孕晚期有发热病史;4例患儿以"呼吸困难或呼吸急促伴呻吟"为主要症状;5例患儿在呼吸机辅助通气、西地那非、肺表面活性物质、米力农等综合治疗基础上给予肝素钠注射液治疗(5~10U/kg,q8h,3~5d),5例患儿均在给药数十分钟内血氧饱和度改善,治疗后4例患儿治愈,1例患儿在家长放弃治疗后死亡。结论:肝素钠联合西地那非、米力农及机械通气等综合治疗可能有益于改善PPHN患儿血氧饱和度,肝素钠辅助治疗可能可以作为新生儿持续肺动脉高压新的治疗方法,值得进一步研究。

Objective:o analyze and discuss the effect and possible mechanism of heparin sodium in the treatment of persistent pulmonary hypertension in newborn in combination with clinical cases,so as to provide a new idea of adjuvant drug therapy and combined therapy for neonates with persistent pulmonary hypertension.Methods:Observational analysis was performed on 5 cases of neonates with continuous pulmonary hypertension treated with heparin sodium in the first Affiliated Hospital of Shihezi University School of Medicine from July 2019 to October2020,to investigate the possible role of heparin sodium in the adjuvant treatment of neonates with continuous pulmonary hypertension.Results:There were 2 premature infants,3 full term infants,2 natural births,3 caesarean sections,3 birth asphyxia,and 1 maternal fever in the third trimester.The main symptoms of 4 cases were"dyspnea or shortness of breath with moaning".Five children were treated with heparin sodium injection(5-10 u/kg,q8 h,3-5 d)on the basis of ventilator assisted ventilation,sildenafil,pulmonary surfactant and milrinone,all the 5 cases were improved in blood oxygen saturation within ten minutes or more,4 cases were cured after treatment,and 1 case died after parents gave up.Conclusion:Heparin sodium combined with sildenafil,milineol and mechanical ventilation may be beneficial to improve the blood oxygen saturation of children with PPHN and heparin sodium adjuvant therapy may be a new treatment method for neonatal persistent pulmonary hypertension which is worthy of further study.