应用一氧化氮吸入治疗新生儿持续性肺动脉高压的临床效果分析

Clinical effectiveness analysis of inhaled nitric oxide for persistent pulmonary hypertension of newborn

目的对一氧化氮吸入(Inhaled nitric oxide,iNO)治疗新生儿持续性肺动脉高压(Persistent pulmonary hypertension of newborn,PPHN)的临床效果进行分析。方法2016年1月至2019年6月我院新生儿病房收治的重度PPHN患儿共80例,分为iNO组(iNO+机械通气)40例和常规组(单独应用机械通气)40例,比较两组患儿住院时间、机械通气时间、氧疗时间、肺动脉压力、血气离子分析及呼吸功能。结果iNO组患儿使用机械通气时间、氧疗时间均小于常规组,肺动脉压力低于常规组,差异均有统计学意义(P<0.05)。iNO组和常规组平均气道压(Mean airway pressure,MAP)、氧合指数(Oxygenation index,OI)及pH值组间、时间及组间×时间交互作用差异有统计学意义(P<0.05)。结论对新生儿持续性肺动脉高压患儿使用一氧化氮吸入联合机械通气治疗可以明显改善患儿呼吸功能,从而减少机械通气时间、氧疗时间和住院时间。

Objective To analyze the clinical effect of inhaled nitric oxide for the neonates with persistent pulmonary hypertension of newborn.Methods A total of 80 neonates with PPHN from January 2016 to June 2019 were collected and divided into iNO group(iNO+mechanical ventilation)and conventional treantment group(mechanical ventilation only)according to the different treatments.The indexes of length of hospital stay,ventilator time,the time of using oxygen,and pulmonary artery pressure,blood gas ion analysis and respiratory function changes were observed and compared between the two groups.Results Treatment with iNO+mechanical ventilation resulted in a rapid decrease in length of hospital stay,ventilator time,the time of using oxygen,pulmonary artery pressure(P<0.05).The mean airway pressure(MAP),oxygenation index(OI)and pH value among the different time points,groups or groups×time points were statistically significant(P<0.05).Conclusion Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the respiratory function of neonates,reduce the time of mechanical ventilation,oxygen therapy and hospitalization.