西地那非与米力农联合机械通气治疗新生儿持续性肺动脉高压的效果比较

Comparison of effects of Sildenafil and Milrinone combined with mechanical ventilation in treatment of persistent pulmonary hypertension in neonates

目的:比较西地那非与米力农联合机械通气治疗新生儿持续性肺动脉高压(PPHN)患儿的效果。方法:选取2019年4月至2022年5月该院收治的142例PPHN患儿进行前瞻性研究,依据随机数字表法将其分为对照组与研究组各71例。对照组行机械通气联合米力农治疗,研究组行机械通气联合西地那非治疗。比较两组临床疗效,治疗前后肺动脉压、肺动脉收缩压、血气分析指标[血氧饱和度(SpO_(2))、氧合指数(OI)、动脉血氧分压(PaO_(2))、吸入氧浓度(FiO_(2))]水平,以及住院时间、机械通气时间和不良反应发生率。结果:研究组治疗总有效率为97.18%(69/71),高于对照组的88.73%(63/71),差异有统计学意义(P<0.05);治疗后,两组肺动脉压、肺动脉收缩压水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);两组Sp O_(2)、Pa O_(2)水平均高于治疗前,且研究组高于对照组,两组OI、FiO_(2)水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05);研究组住院时间、机械通气时间均短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:西地那非联合机械通气治疗PPHN患儿可提高治疗总有效率,缩短机械通气时间、住院时间,降低肺动脉压、肺动脉收缩压水平,其效果优于米力农联合机械通气治疗。

Objective:To compare effects of Sildenafil and Milrinone combined with mechanical ventilation in treatment of persistent pulmonary hypertension in neonates(PPHN).Methods:A prospective study was conducted on 142 children with PPHN admitted to the hospital from April 2019 to May 2022.According to the random number table method,they were divided into control group and study group,71 cases in each group.The control group was treated with mechanical ventilation combined with Milrinone,while the study group was treated with mechanical ventilation combined with Sildenafil.The clinical efficacy,the pulmonary artery pressure,the pulmonary artery systolic pressure,the blood gas analysis indexes[oxygen saturation(SpO_(2)),oxygenation index(OI),arterial partial pressure of oxygen(PaO_(2)),inhaled oxygen concentration(FiO_(2))]levels,the hospitalization time,the mechanical ventilation time,and the incidence of adverse reactions were compared between the two groups before and after the treatment.Results:The total effective rate of the study group was 97.18%(69/71),which was higher than 88.73%(63/71)of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of pulmonary artery pressure and pulmonary artery systolic pressure in the two groups were lower than those before the treatment,those in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of SpO_(2)and PaO_(2)in the two groups were higher than those before the treatment,and those in the study group were higher than those in the control group;the levels of OI and FiO_(2)of the two groups were lower than those before the treatment,and those in the study group were lower than those in the control group;and the differences were statistically significant(P<0.05).The hospitalization time and the mechanical ventilation time of the study group were shorter than those of the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusions:Sildenafil combined with mechanical ventilation in the treatment of the children with PPHN can improve the total effective rate of treatment,shorten the mechanical ventilation time and the hospitalization time,and reduce the levels of pulmonary artery pressure and pulmonary artery systolic pressure.Moreover,it is superior to Milrinone combined with mechanical ventilation.