波生坦联合雾化吸入硝普钠对先心病伴肺动脉高压患儿肺动脉血流动力学及心脏功能的影响分析

Effect of Bosentan Combined with Aerosol Nhalation of Sodium Nitroprusside on Pulmonary Artery Hemodynamics and Cardiac Function in Children with Congenital Heart Disease Associated with Pulmonary Hypertension

目的探究波生坦联合雾化吸入硝普钠对先天性心脏病(简称先心性)伴肺动脉高压患儿动脉血流动力学及心脏功能的影响。方法随机选取2021年12月—2023年2月贵阳市妇幼保健院收治的90例先心病伴肺动脉高压患儿为研究对象,根据不同治疗方法分为对照组和观察组,每组45例。对照组予以雾化吸入硝普钠治疗,观察组予以波生坦联合雾化吸入硝普钠治疗,两组患儿均持续治疗2个月。对比两组患儿的临床疗效、肺动脉血流动力学水平、心脏功能水平、肺功能水平及不良反应发生情况。结果观察组治疗总有效率为97.78%(44/45),高于对照组的82.22%(37/45),差异有统计学意义(χ^(2)=4.444,P=0.035);观察组治疗后肺血管阻力、平均肺动脉压低于对照组,差异有统计学意义(P均<0.05);治疗后两组患儿的平均动脉压比较,差异无统计学意义(P>0.05);治疗后,观察组心功能指数、心排血量、每搏输出量高于对照组,差异有统计学意义(P均<0.05);治疗后,观察组动脉血氧分压、氧合指数高于对照组,差异有统计学意义(P均<0.05);两组患儿的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论在先心病伴肺动脉高压患儿中,使用波生坦联合雾化吸入硝普钠治疗可有效改善患儿的肺动脉血流动力学,促进心脏功能与肺功能恢复正常,且不良反应较小。

Objective To investigate the effects of bosentan combined with atomized inhalation of sodium nitroprus-side on arterial hemodynamics and cardiac function in children with congenital heart disease(CHD)and pulmonary hypertension.Methods 90 children with CHD with pulmonary artery hypertension admitted to Guiyang Maternal and Child Health Hospital from December 2021 to February 2023 were randomly selected as the research objects.Accord-ing to different treatment methods,they were divided into control group and observation group,with 45 cases in each group.The control group was treated with atomized inhalation of sodium nitroprusside,and the observation group was treated with bosentan combined with atomized inhalation of sodium nitroprusside.Both groups were treated for 2 months.The clinical efficacy,pulmonary artery hemodynamics,cardiac function,pulmonary function and adverse reac-tions were compared between the two groups.Results The total effective rate of the observation group was 97.78%(44/45),which was higher than 82.22%(37/45)of the control group,and the difference was statistically significant(χ^(2)=4.444,P=0.035).After treatment,the pulmonary vascular resistance and mean pulmonary artery pressure in the obser-vation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).There was no significant difference in mean arterial pressure between the two groups after treatment(P>0.05).After treatment,the cardiac index,cardiac output and stroke volume in the observation group were higher than those in the control group,and the differences were statistically significant(all P<0.05).After treatment,the arterial partial pressure of oxygen and oxygenation index in the observation group were higher than those in the control group,and the differences were statistically significant(both P<0.05).There was no significant difference in total incidence of ad-verse reactions between the two groups(P>0.05).Conclusion In children with CHD and pulmonary hypertension,the treatment of bosentan combined with aerosol inhalation of sodium nitroprusside can effectively improve the pulmonary artery hemodynamics of children,promote the recovery of cardiac function and pulmonary function,and have fewer ad-verse reactions.