不同血管扩张剂联合应用治疗新生儿持续肺动脉高压的临床观察

The Cbservation of the Application of Combination of Different Vasodilators on PPHN

目的：观察不同血管扩张剂联合应用治疗新生儿持续肺动脉高压（PPHN）的疗效。方法：将69例PPHN患儿分为三组,A组给予枸橼酸西地那非片鼻饲;B组枸橼酸西地那非片鼻饲同时予硫酸镁应用;C组硫酸镁应用同时予酚妥拉明应用;余综合治疗均相同。比较三组治疗前后平均肺动脉压力（PAMP）、体循环收缩压（SBP）、氧合指数（OI）、动脉血氧分压（PaO2）及治疗有效率。结果：三组治疗后观察指标明显改善,PAMP、OI、PaO2在治疗后各时点,与治疗前比较差异显著;SBP治疗前、后比较,A组无明显差异,B组、C组治疗后1-2h均下降,差异显著,且C组下降较B组明显,P〈0.05;B组治疗总有效率高于其他两组,差异显著。结论：西地那非联合硫酸镁治疗新生儿PPHN能更快改善氧合、降低肺动脉压力,且对体循环SBP影响较小,疗效肯定,值得临床推广应用。

Objective：Our goal was to observe the synergetic effects of different vasodilators on PPHN.Methods：We collected 69 neonates with PPHN and divided them into three groups（e.g.A,B,C）.Group A were treated with sildenafil via oral feeding tube.Group B were treated with both sildenafil and magnesium sulfate.Group C were treated with both magnesium sulfate and phentolamine.The rest of the therapy were conducted in the same fashion in these three groups.Then we compared PAMP,SBP,OI and PaO2 values before and after treatment.Results：Based on the observation,in different time points after the treatments,all the three groups have significantly improved in PAMP and OI and PaO2 values,compared with the values before treatment.The SBP value did not show significant difference in group A,but significantly decreased after 1-2hafter treatments in group B and group C.Also the decrease of group C is more noticeable than group B（P〈0.05）.The results prove that the treatment effect in group B is more noticeable than other groups.Conclusion：The conjunction of sildenafil and magnesium sulfate proved to be more effective in increasing OI values and decreasing PAMP values,but exerted little effect on changing the SBP values.Therefore,the conjunction of sildenafil and magnesium sulfateis recommended to be clinically applied on.