米力农和西地那非分别联合机械通气治疗新生儿PPHN疗效评价

Evaluation of the effect of milrinone and sildenafil combined with mechanical ventilation on neonatal PPHN

目的探讨米力农和西地那非分别联合机械通气治疗新生儿持续性肺动脉高压(PPHN)及对患儿氧合功能、疾病转归的影响。方法选取2018年1月~2021年12月确诊为PPHN的新生儿共80例为研究对象。按照简单数字表法随机分为观察组和对照组,每组各40例。对照组给予米力农联合机械通气治疗,观察组给予西地那非联合机械通气治疗。比较两组患儿治疗情况。比较两组患儿治疗前后肺动脉收缩压(PASP)及肺动脉压(PAP)数值。比较两组患儿治疗前后血气指标:动脉血氧分压(PaO_(2))、动脉二氧化碳分压(PaCO_(2))、血氧饱和度(SpO_(2))。比较两组患儿治疗前后生命体征指标。比较两组患儿疾病转归情况。结果观察组机械通气时间、住院时间、氧疗时间均少于对照组(P<0.05)。与治疗前比较,治疗后两组患儿PASP及PAP数值均降低,观察组低于对照组(P<0.05)。与治疗前比较,治疗后两组患儿PaO_(2)、SpO_(2)数值均升高,观察组高于对照组(P<0.05),两组PaCO_(2)数值变化差异无统计学意义(P>0.05)。与治疗比较,两组患儿RR、HR、SBP数值均降低,观察组低于对照组(P<0.05)。观察组痊愈人数多于对照组(P<0.05)。结论西地那非联合机械通气治疗新生儿PPHN具有明显疗效,可降低患儿肺动脉压,稳定患儿生命体征。

Objective To investigate the effects of milrinone and sildenafil combined with mechanical ventilation in the treatment of neonatal persistent pulmonary hypertension(PPHN)and its effect on oxygenation function and disease outcome.Methods A total of 80 neonates diagnosed with PPHN in our hospital from January 2018 to December 2021 were selected as the study subjects.According to the simple number table method,they were randomly divided into observation group and control group,40 cases in each group.The control group was treated with milrinone combined with mechanical ventilation,and the observation group was treated with sildenafil combined with mechanical ventilation.The treatment of the two groups was compared.Pulmonary artery systolic pressure(PASP)and pulmonary artery pressure(PAP)were compared between the two groups before and after treatment.Blood gas indexes of two groups before and after treatment were compared:arterial partial pressure of oxygen(Pa O_(2)),arterial partial pressure of carbon dioxide(Pa CO_(2))and oxygen saturation(Sp O_(2)).The vital signs of the two groups were compared before and after treatment.The disease outcomes of the two groups were compared.Results The duration of mechanical ventilation,hospital stay and oxygen therapy in the observation group were shorter than those in the control group(P<0.05).Compared with before treatment,PASP and PAP values in the two groups were decreased after treatment,and the observation group was lower than the control group(P<0.05).Compared with before treatment,the values of PaO_(2) and SpO_(2) in the two groups increased after treatment,and the observation group was higher than the control group(P<0.05).There was no significant difference in PaCO_(2) values between the two groups(P>0.05).Compared with the treatment,RR,HR and SBP values in two groups were decreased,and the observation group was lower than the control group(P<0.05).The number of patients cured in observation group was more than control group(P<0.05).Conclusion Sildenafil combined with mechanical ventilation has obvious efficacy in the treatment of neonatal PPHN,which can reduce pulmonary artery pressure and stabilize vital signs.