一氧化氮吸入联合高频振荡通气治疗新生儿持续性肺动脉高压的效果分析

Analysis on the Effect of Nitric Oxide Inhalation Combined with HFOV in the Treatment of Children with PPHN

目的探究一氧化氮(NO)吸入联合高频振荡通气(HFOV)治疗新生儿持续性肺动脉高压(PPHN)的效果。方法选取某院2017年6月1日-2019年6月1日收治的120例PPHN新生儿作为研究对象,对照组40例给予HFOV治疗,观察A组40例给予NO吸入联合HFOV治疗,观察B组40例给予米力农联合HFOV治疗。比较3组临床治疗效果、治疗前后血气指标的动脉血二氧化碳分压和动脉血氧分压;肺功能的吸入氧浓度、氧合指数和肺动脉压力及血清D-二聚体、脑钠肽、C反应蛋白水平,并统计对比3组机械通气时间、氧疗时间、住院时间、不良事件发生情况。结果观察A组、观察B组总有效率高于对照组(P<0.05);治疗24小时、48小时后,观察A组PaCO2低于对照组、观察B组,Pa O2高于对照组、观察B组,差异有统计学意义(P<0.05);治疗24小时、48小时后,观察A组FiO2、OI、PAP低于对照组、观察B组,观察B组FiO2、OI、PAP低于对照组,差异有统计学意义(P<0.05);治疗24小时、48小时后,观察A组血清D-D、BNP、CRP水平低于对照组、观察B组,观察B组血清D-D、BNP、CRP水平低于对照组,差异有统计学意义(P<0.05);观察A组机械通气时间、氧疗时间、住院时间短于对照组、观察B组,观察B组短于对照组,差异有统计学意义(P<0.05);3组不良事件发生率比较,差异无统计学意义(P>0.05)。结论 NO吸入联合HFOV治疗PPHN患儿,可调节血清D-D、BNP、CRP水平,改善血气指标、肺功能,疗效显著,且安全性高。

Objective To explore the effect of nitric oxide(NO) inhalation combined with high frequency oscillatory ventilation(HFOV) in the treatment of neonatal persistent pulmonary hypertension(PPHN). Methods A total of 120 patients with PPHN admitted to a hospital from June 1, 2017 to June 1, 2019 were selected as the research object. 40 cases in the control group were treated with HFOV, 40 cases in group A were given NO inhalation combined with HFOV treatment, and 40 cases in group B were given Milinone combined with HFOV treatment. Comparing the clinical treatment effect, blood gas index [arterial blood carbon dioxide partial pressure(PaCO2), arterial blood oxygen partial pressure(Pa O2)], lung function [inhaled oxygen concentration(FiO2), oxygenation index(OI), pulmonary artery pressure(PAP)], serum D-dimer(D-D), brain natriuretic peptide(BNP), C-reactive protein(CRP) levels before and after treatment of the three groups. And statistically comparing the mechanical ventilation time, oxygen therapy time, hospitalization time and adverse events of the three groups. Results The total effective rate of observation group A and observation group B was higher than that of the control group(P<0.05);after 24 hours and 48 hours of treatment, PaCO2 in observation group A was lower than that in control group and observation group B, and PaO2 was higher in control group and observation group B, the differences were statistically significant(P<0.05);after 24 hours and 48 hours of treatment, the FiO2, OI, and PAP in observation group A were lower than those in the control group and the observation group B, and the FiO2, OI, and PAP in observation group B were lower than the control group, and the differences were statistically significant(P<0.05);after 24 hours and 48 hours of treatment, the levels of serum D-D, BNP, and CRP in observation group A were lower than those in control group and observation group B, serum D-D, BNP, and CRP levels in observation group B were lower than those in the control group, and the differences were statistically significant(P<0.05);in observation group A, the mechanical ventilation time, oxygen therapy time and hospital stay were shorter than those in control group, observation group B, and observation group B were shorter than control group, the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse events between the three groups(P>0.05). Conclusions NO inhalation combined with HFOV in the treatment of children with PPHN could adjust serum D-D, BNP, CRP levels, improve blood gas indexes and lung function, and had a significant effect and high safety.