硝普钠联合米力农治疗新生儿持续性肺动脉高压疗效研究

Study on clinical effect of sodium nitroprusside and milrinone on the new-born with persistent pulmonary hypertension

目的探讨硝普钠雾化吸入联合米力农泵入治疗新生儿持续性肺动脉高压(PPHN)的疗效。方法选择2012年12月至2017年12月湖南中医药大学第三附属医院新生儿重症监护病房收治的40例经彩色多普勒超声心动图检查确诊的PPHN患儿,随机分为对照组和治疗组,每组20例。对照组除一般的综合治疗外,给予米力农静脉泵入治疗3 d;治疗组在对照组基础上加用硝普钠雾化吸入治疗。记录2组患儿治疗前后临床表现、心率、呼吸、血压、血氧饱和度(SaO_2)、肺动脉收缩压(PASP)、平均肺动脉压(MPAP)、左室射血分数(LVEF)及疗效并进行比较。结果治疗组患儿治疗后各项指标(总有效率、心率、呼吸、血压、SaO_2、PASP、MPAP、LVEF)均优于对照组,差异均有统计学意义(P<0.05)。结论硝普钠雾化吸入联合米力农泵入治疗PPHN疗效肯定,且无严重不良反应,可广泛应用于临床。

Objective To observe the clinical effect of sodium nitroprusside and mikinone on the new-born with persistent pulmonary hypertension （PPHN）. Methods 40 cases new-born with PPHN admitted to the neonatal intensive care unit of the Third Affiliated Hospital of Hunan University of Chinese Medicine from December 2012 to December 2017 by the color doppler echocardiography were selected, and they were divided randomly into treatment group （20 cases） and control group （20 cases）. General complex treatment and mili＇inone （three days） were used in control group, while the treatment group was treated by atomizing imhalation of sodium nitroprusside on the basis of the control group. Clinical manifestation, heart rate ,respiration rate, blood pressme, degree of blood oxygen saturation （Sa02）, puhnonary arterial systolic pressure （PASP）, mean pulmonary arterial pressure （MPAP） , left ventricular ejection fraction （LVEF）and curative effect of both groups were observed before and after the treatment. Results The total effective rate,heart rate,respiration rate,blood pressure.SaO2,PASP,MPAP and LVEF in treatment group were significantly superior to those of control group, the differences were statistically significant （P〈0.05）. Conclusion The clinical effect of sodium nitroprusside and mili＇inone on the new-born with PPHN is affimmtive, and the rate of adverse reaction is also lower. Therefore, sodium nitroprusside and mili＇inone is a useful formula for treating PPHN and worth popularizing.