重症新生儿呼吸窘迫综合征患儿吸入一氧化氮后肺血流与氧合动态变化  

The effects of nitric oxide inhalation on the systemic oxygenation and pulmonary blood flow in premature infants with severe respiratory distress syndrome

作　　者：杜立中[1] 孙眉月[1] 颜艳玲[1] 洪文澜[1] 施丽萍[1] 邵洁[1] 

机构地区：[1]浙江医科大学附属儿童医院

出　　处：《中华儿科杂志》1997年第7期374-376,共3页Chinese Journal of Pediatrics

摘　　要：为探讨吸入一氧化氮（ＮＯ）对早产儿呼吸窘迫综合征（ＲＤＳ）的疗效，对１０例ＲＤＳ患儿进行了吸入ＮＯ治疗，浓度以２０ｐｐｍ开始，４小时后降为６ｐｐｍ，持续至２４小时。同时在吸入前、吸入后３０分钟及吸入后１２～１６小时动态观察平均肺动脉血流速度及体循环氧合变化。结果：吸入ＮＯ后有８例患儿血氧饱和度迅速上升；吸入３０分钟后平均肺动脉血流速度显著增加（Ｐ＜０．０５），氧合指数显著改善（Ｐ＜０．０５）；以６ｐｐｍ浓度维持至２４小时，氧合指数持续改善，肺动脉血流继续增加。提示：吸入ＮＯ能显著降低重症ＲＤＳ患儿的肺血管阻力，改善氧合；采用无创伤性方法测定平均肺动脉血流速度对选择吸入ＮＯ适应证。The efficacy of nitric oxide (NO) inhalation was studied in ten premature infants with severe respiratory distress syndrome (RDS). The infants were initially treated with inhaled NO at 20 ppm for 4 hours and then at 6 ppm for 20 hours. Systemic oxygenation and pulmonary blood flow velocity were evaluated before NO treatment, 30 minutes following NO (20 ppm) inhalation and 12 16 hours following NO(6 ppm) inhalation. In 8 of 10 infants, oxygen saturation promptly improved. In all the infants, oxygenation index decreased significantly ( P <0.05) and mean pulmonary blood flow velocity (MPBFV) increased significantly ( P <0.05) at 30 minutes following NO inhalation. Sustained improvement in oxygenation index and increase in MPBFV were achieved at 12 16 hours following NO (6 ppm) inhalation. The results indicate that low dose NO inhalation cause sustained improvement in systemic oxygenation and decrease in pulmonary vascular resistance in premature infants with severe RDS. Measurement of MPBFV is important in selection of patients for initiating NO therapy and evaluating clinical responsiveness.

关 键 词：呼吸窘迫综合征 一氧小氮 血流速度 早产儿 

分 类 号：R563.805[医药卫生—呼吸系统] R722.6[医药卫生—内科学]