小剂量盐酸多巴胺联合高频振荡通气治疗新生儿持续性肺动脉高压的应用疗效及安全性研究

Effects and Safety of Small Doses Dopamine Hydrochloride Combined with High Frequency Oscillatory Ventilation in Newborns with Persistent Pulmonary Hypertension

目的研究小剂量盐酸多巴胺联合高频振荡通气在新生儿持续性肺动脉高压(PPHN)中的应用效果及安全性。方法选取2014年4月-2016年8月西安市儿童医院收治的68例PPHN患儿,随机分为研究组和对照组,各34例。对照组给予镇静、抗感染、高频振荡通气等常规治疗,而研究组在高频振荡通气等常规治疗基础上给予小剂量盐酸多巴胺静脉泵入治疗。通过比较动脉血气指标、实验室指标、PASP、BNP、EPO指标、呼吸机使用时间、临床疗效及不良反应情况对效果进行评价。结果治疗后,研究组动脉血气指标、实验室指标、PASP、BNP、EPO指标水平均明显的优于对照组,差异具有统计学意义(P<0.05);研究组呼吸机使用时间明显少于对照组,差异具有统计学意义(P<0.05);研究组治疗总有效率为97.06%,对照组为82.35%,差异具有统计学意义(P<0.05);两组均未出现严重不良反应。结论小剂量盐酸多巴胺联合高频振荡通气治疗新生儿持续性肺动脉高压的效果显著,能显著改善患儿血气指标、高压体征,调节缺氧诱导因子水平,安全性较高。

Objective To study the application effects and the safety of small doses dopamine hydrochloride combined with high frequency oscillatory ventilation in the treatment of persistent pulmonary hypertension of newborn（PPHN）.Methods The 68 patients of PPHN selected from April 2014 to August 2016 from Shanxi Provincial Peoples＇ Hospital were randomly divided into study group and control group, 34 cases of each group. The control group was given conventional treatment of sedation, anti-infection, high frequency oscillatory ventilation and so on. The study group was given small doses dopamine hydrochloride intravenous infusion therapy on the basis of conventional treatment. Clinical effects were evaluated by comparing arterial blood gas index, laboratory index, PASP, BNP, EPO index, ventilator use time, clinical efficacy and adverse reaction. Results After treatment, arterial blood gas index,laboratory index, PASP, BNP, EPO levels of study group were significantly better than control group（P〈0.05）.The ventilator used time of study group was significantly less than control group（P〈0.05）. The total effective rate was 97.06% in the study group, and 82.35% in the control group（P〈0.05）. There were no serious adverse events in both groups during treatment. Conclusion Small doses dopamine hydrochloride combined with high frequency oscillatory ventilation in the treatment of persistent pulmonary hypertension of newborn have significant effects,which can significantly improve the patient＇s blood gas index and high blood pressure signs, regulate the level of hypoxia inducible factor with higher safety.