小剂量硝酸甘油联合酚妥拉明持续静脉滴注治疗新生儿肺动脉高压的疗效  

Effect of Small Dose of Nitroglycerin Combined with Phentolamine Intravenows Injection Treatment on Newborn Infants with Pulmonary Artery Hypertension

作　　者：战美丽[1] 赵君[1] 石临静[1] 田玉爱[1] 徐桂霞[1] 

机构地区：[1]聊城市第二人民医院新生儿科,山东聊城252601

出　　处：《实用儿科临床杂志》2008年第14期1105-1107,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨小剂量硝酸甘油联合酚妥拉明持续静脉滴注治疗新生儿肺动脉高压（PAH）的疗效。方法2000年6月-2006年12月经超声心动图检查证实存在PAH的新生儿178例为研究对象。随机分为对照组85例,治疗组93例。其中先天性心脏病或肺结构异常42例（对照组20例,治疗组22例）;其他病因所致者136例（对照组65例,治疗组71例）。患儿经皮测血氧饱和度（TcSaO2）均低于85%。对照组予综合治疗加酚妥拉明0.2~0.3mg/（kg·min）,按10μg/（kg·min）的速度泵入,1次/d,连用3d;治疗组在此基础上加用硝酸甘油,0.3~0.5μg/（kg·min）,连续泵入6h,若无效每天递增0.3~0.5μg/（kg·min）,最多应用7d。所有患儿治疗前后进行临床表现、心率、呼吸、血压、TcSaO2及平均肺动脉压（MPAP）监测。结果治疗组总有效率、MPAP及平均TcSaO2治疗前后与对照组比较差异均有显著性（Pa〈0.05）,其中二组其他病因患儿比较差异亦有非常显著性（Pa〈0.01）。不同病因、不同MPAP治疗前后比较也有显著性差异（Pa〈0.05）。治疗组体循环血压均无明显变化。结论小剂量硝酸甘油联合酚妥拉明持续静脉滴注治疗PAH新生儿疗效优于单独应用酚妥拉明,且无严重不良反应。Objective To explore the effect of small dose of nitroglycerin combined with phentolamine intravenows injection treatment on neonatal pulmonary artery hypertension （PAH）. Methods One hundred and seventy - eight newborn infants were selected who were manifes- ted PAH by echo - eardiographie in newborns in our hospital from Jun. 2000 to Dee. 2006. They were divided into 2 groups randomly, control group （85 cases） and therapeutic group （93 cases）. Among them 42 cases had congenital heart disease or pulmonary disease,control group included 20 eases and therapeutic group included 22 cases. One hundred and thirty - six eases had other disease, control group included 65 eases and therapeutic group included 71 cases. The transeutaneous oxygen saturation （TeSaO2） of all newborn infants were below 85%. Control group： complex treatment added phentolamine 0.2 - 0.3 mg/（ kg· min ） which was pumped by 10 μg/（ kg· min ）, 1time/d, for 3 d. Therapeutic group： on the base of control group, added nitroglycerin which pumped 6 hours continuously by 0.3 - 0. 5 μg/（ kg· min ） first then added 0.3 - 0.5 μg/（ kg· min） dayly if no effect according to the course of disease and used for 7 d at the most. The clinical manifestations, heart rate, breath, blood pressure,TeSaO2 and mean pulmonary arterial pressure （MPAP） of all patients were detected before and after treatment. Results There were significant differences in the total effective rate, MPAP and average TcSaO2 before and after treatment between therapeutic group and control group（ P 〈0.05 ）. There were obvious differences in other diseases group（ Pa 〈 0.01 ）. There were also diffe- rences in different MPAP among different diseases before and after treatment（ Pa 〈 0.05 ）. There were no obvious affects on body circulation in all of therapeutic group. Conclusions The effect of a small dose of nitroglycerin combined infant with phentolamine on newborn infant with PAH is superior to that of the treatment with phentolamine al

关 键 词：肺动脉高压 硝酸甘油 酚妥拉明 治疗 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]