新生儿持续性肺动脉高压应用高频振荡通气与西地那非联合治疗的疗效观察

Observation on the curative effect of high-frequency oscillatory ventilation combined with sildenafil in persistent pulmonary hypertension of the newborn

目的观察新生儿持续性肺动脉高压(PPHN)应用高频振荡通气与西地那非联合治疗的疗效。方法选取83例PPHN患儿,随机分为对照组(高频振荡通气治疗,42例)和联合组(高频振荡通气+西地那非治疗,41例)。比较两组临床疗效,治疗前后肺动脉收缩压(SPAP),体循环收缩压(SBP),血气指标[动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO_(2))]及治疗期间不良反应发生率。结果联合组总有效率90.24%高于对照组的71.43%(P<0.05);对照组治疗后体循环SBP(67.54±6.82)mm Hg(1 mm Hg=0.133 kPa),联合组治疗后体循环SBP(66.23±6.41)mm Hg,两组体循环SBP比较差异无统计学意义(P>0.05),联合组治疗后SPAP(28.95±4.25)mm Hg低于对照组的(37.59±4.36)mm Hg(P<0.05);联合组治疗后SaO2(98.48±10.72)%、PaO2(89.69±9.59)mm Hg高于对照组的(91.39±10.23)%、(82.48±9.76)mm Hg,联合组治疗后PaCO_(2)(34.69±4.69)mm Hg低于对照组的(48.46±5.21)mm Hg(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PPHN采用高频振荡通气联合西地那非治疗疗效确切,可降低肺动脉压,改善呼吸功能,值得临床推广运用。

Objective To observe the curative effect of high-frequency oscillatory ventilation combined with sildenafil in persistent pulmonary hypertension of the newborn(PPHN).Methods A total of 83 newborns with PPHN were selected and randomly divided into a control group(42 cases,high-frequency oscillatory ventilation)and a combination group(41 cases,high-frequency oscillatory ventilation+sildenafil treatment).Both groups were compared in terms of clinical efficacy,systolic pulmonary artery pressure(SPAP),systemic systolic blood pressure(SBP),blood gas index[arterial oxygen saturation(SaO2),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO_(2))]before and after treatment,and incidence of adverse reactions during treatment.Results The total effective rate of 90.24%in the combination group was higher than 71.43%in the control group(P<0.05).After treatment,the systemic SBP of the control group was(67.54±6.82)mm Hg(1 mm Hg=0.133 kPa)and that of the combination group was(66.23±6.41)mm Hg;there was no significant difference in the systemic SBP between the two groups(P>0.05).After treatment,SPAP of(28.95±4.25)mm Hg in the combination group was lower than(37.59±4.36)mm Hg in the control group(P<0.05).After treatment,the combination group had SaO2 of(98.48±10.72)%and PaO2(89.69±9.59)mm Hg,which were higher than(91.39±10.23)%and(82.48±9.76)mm Hg in the control group;PaCO_(2) of(34.69±4.69)mm Hg in the combination group was lower than(48.46±5.21)mm Hg in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion High-frequency oscillatory ventilation combined with sildenafil is effective in the treatment of PPHN,which can reduce pulmonary artery pressure,improve respiratory function,and is worthy of clinical application.