外源性一氧化氮吸入对新生儿低氧性呼吸衰竭症状及心功能的影响

Influence of exogenous nitric oxide inhalation on the symptom of hypoxic respiratory failure and the cardiac function in neonates

目的分析外源性一氧化氮吸入对新生儿低氧性呼吸衰竭症状及心功能的影响。方法选取2013年8月至2014年9月开封市儿童医院新生儿科收治的低氧性呼吸衰竭新生儿68例为研究对象,随机分为观察组和对照组各34例。对照组给予机械通入氧气治疗,持续机械间歇正压通气,根据患儿血气变化及时调整通气参数。观察组在对照组基础上给予一氧化氮吸入治疗,比较两组治疗前后氧合指数、血PaO_2、血PaCO_2、平均气道压,对比两组左室射血分数、心搏指数、心率,同时观察不良反应。结果治疗后观察组氧合指数5.23±1.88、PaO_2(52.29±2.86)mm Hg,低于对照组8.64±1.75,(66.34±1.57)mm Hg;PaCO_2(45.67±2.38)mm Hg,平均气道压(12.95±1.27)cm H_2O,左室射血分数(79.83±1.35)%,心搏指数(3.64±0.15)L/(min·m^2),心率(79.36±1.11)次/min,显著高于对照组(35.61±2.29)mm Hg,(9.53±1.37)cm H_2O,(74.25±1.52)%,(3.15±0.38)L/(min·m^2),(75.27±1.18)次/min,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论外源性吸入一氧化氮治疗新生儿低氧性呼吸衰竭效果较好,且能明显改善患儿心功能,不良反应轻,值得在临床推广应用。

Objective To analyze the influence of exogenous nitric oxide inhalation on the symptom of hypoxic respiratory failure and the cardiac function in neonates.Methods A total of68neonates with hypoxic respiratory failure treated in Kaifeng Children's Hospital from Aug.2013to Sep.2014were selected as the research subjects,and then were divided randomly into two groups of34cases,the observation group and the control group.Both groups were treated by mechanical ventilation with oxygen and continuous mechanical intermittent positive pressure ventilation,and the ventilation parameters were adjusted in time with the changes in blood gas of the neonates.The observation group was additionally treated with nitric oxide inhalation.Compare the following indexes between the two groups before and after treatment:oxygenation index,blood PaO2,blood PaCO2and mean airway pressure.Make a contrast of left ventricular ejection fraction,cardiac index and heart rate between the two groups.Meanwhile,the adverse reactions were compared.Results After treatment,the oxygenation index was5.23±1.88and PaO2was(52.29±2.86)mm Hg in the observation group,significantly lower than those of control group:8.64±1.75and(66.34±1.57)mm Hg;PaCO2was(45.67±2.38)mm Hg,mean airway pressure was(12.95±1.27)cm H2O,left ventricular ejection fraction(LVEF)was(79.83±1.35)%,cardiac index was(3.64±0.15)L/(min·m2)and heart rate was(79.36±1.11)/min in the observation group,which were significantly higher than those in the control group:(35.61±2.29)mm Hg,(95.3±1.37)cm H2O,(74.25±1.52)%,(3.15±0.38)L/(min·m2)and(75.27±1.18)/min,the difference being statistically significant(P<0.05).There was no statistical difference in the incidence of adverse reactions(P>0.05)between the two groups Conclusion Exogenous nitric oxide inhalation has good effect in the treatment of neonates with hypoxic respiratory failure;it can significantly improve the cardiac function of the neonates with milder adverse reactions,which is worth clinical popularizing and applying.