新生儿持续性肺动脉高压治疗进展

Advances in Treatment of Persistent Pulmonary Hypertension of the Newborns

新生儿持续性肺动脉高压(PPHN)是新生儿期的一种常见急危重症,虽然有多种治疗方法,但其死亡率和发病率仍较高。目前,针对PPHN患儿的治疗方法包括改进通气策略以优化肺泡募集,尽量减少氧气毒性,并同时使用肺表面活性剂和一氧化氮吸入。这些改进导致需要体外膜肺氧合治疗的PPHN患儿大幅度减少。PPHN最新的治疗方法包括全身或局部吸入给予血管扩张药,如磷酸二酯酶抑制剂、前列腺素类和内皮素受体拮抗剂等,使用这些药物可能会进一步降低PPHN相关的发病率和死亡率,但未来需进一步研究。

Persistent pulmonary hypertension of the newborn(PPHN)is a serious medical emergency in the neonatal period.Despite numerous modalities of treatment available,PPHN has a high rate of mortality and morbidity.At present,the treatment of infants with PPHN has included improved ventilation strategies to optimize alveolar recruitment and minimize oxygen toxicity,paired with the therapeutic use of surfactant and inhaled nitric oxide.These improvements have led to a substantial decrease in the number of PPHN patients requiring extracorporeal membrane oxygenation.The latest treatments for PPHN include systemic or local inhalation of vasodilators,such as phosphodiesterase inhibitors,prostaglandins and endothelin receptor antagonists,etc.The use of these drugs may further reduce the morbidity and mortality associated with PPHN,although further research is needed in the future.