一氧化氮吸入对新生儿重度肺动脉高压患儿PaO_(2)、PaCO_(2)、SaO_(2)及SPAP、SBP的影响

Effects of Nitric Oxide Inhalation on PaO_(2),PaCO_(2),SaO_(2),SPAP and SBP in Neonates with Severe Pulmonary Hypertension

目的探究一氧化氮吸入对新生儿重度肺动脉高压患儿动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))及肺动脉收缩压(SPAP)和体循环收缩压(SBP)的影响。方法选取我院2016年1月至2021年9月接收的58例新生儿重度肺动脉高压患儿为研究对象,分为观察组和对照组(按照随机数表法),每组均为29例。对照组患儿实施机械通气联合血管收缩的药物治疗方案,观察组患儿在对照组治疗方案的基础上,联合一氧化氮吸入的治疗方法,观察并记录两组患儿治疗前和治疗结束24小时后的相关指标【动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))】,同时测定治疗前后患儿的肺动脉收缩压(SPAP),并且测试体循环收缩压(SBP)。结果治疗前观察组与对照组患儿的血气指标(PaO_(2)、PaCO_(2)、SaO_(2))数据相当,治疗24h后,两组患儿PaO_(2)和SaO_(2)的检测值升高,PaCO_(2)的测试值降低,而且观察组数据升高和降低程度程度大于优于对照组;两组患儿体内的SBP水平均有所降低,SPAP水平均有所下降,而观察组降低和升高程度较大,显著大于对照组,P<0.05。结论一氧化氮吸入对新生儿重度肺动脉高压患儿的治疗改善作用显著,能有效改善患儿体内PaO_(2)、PaCO_(2)、SaO_(2)及SPAP、SBP的水平,临床效果良好,安全性也得到了验证,值得推广使用。

Objective To explore the effects of nitric oxide inhalation on arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),arterial oxygen saturation(SaO_(2)),pulmonary artery systolic pressure(SPAP)and systemic systolic pressure(SBP)in neonates with severe pulmonary hypertension.Methods 58 newborns with severe pulmonary hypertension received in our hospital from January 2016 to September 2021 were selected as the research objects,and were divided into observation group and control group(according to the random number table method),with 29 cases in each group.The children in the control group were treated with mechanical ventilation combined with vasoconstriction.On the basis of the treatment plan in the control group,the children in the observation group were treated with nitric oxide inhalation.The relevant indicators[arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),arterial oxygen saturation(SaO_(2))]of the two groups before treatment and 24 hours after the end of treatment were observed and recorded.Pulmonary artery systolic pressure(SPAP)and systemic systolic pressure(SBP)were measured before and after treatment.Results Before treatment,the data of blood gas indexes(PaO_(2),PaCO_(2),SaO_(2))in the observation group and the control group were equivalent.After 24 hours of treatment,the detection values of PaO_(2) and SaO_(2) in the two groups increased,and the test values of PaCO_(2) decreased,and the degree of increase and decrease of the data in the observation group was greater than that in the control group;The levels of SBP and SPAP in both groups decreased,while the levels of SBP and SPAP in the observation group were significantly higher than those in the control group(p<0.05).Conclusion Nitric oxide inhalation can significantly improve the treatment of neonates with severe pulmonary hypertension.It can effectively improve the levels of PaO_(2),PaCO_(2),SaO_(2),SPAP and SBP.The clinical effect is good and the safety has been verified.It is worth popularizing.