一氧化氮对早产儿肺功能的影响  

Influence of Nitric oxide to lung function of premature

作　　者：黄柏枝[1] 麦润婵[1] 

机构地区：[1]广东省东莞市太平人民医院,广东东莞523900

出　　处：《中国医药导报》2013年第1期53-54,57,共3页China Medical Herald

摘　　要：目的探讨吸入一氧化氮(NO)对早产儿肺功能的影响。方法选择我院2008年2月～2012年2月收治入院的新生儿呼吸窘迫综合征(NRDS)患儿60例,将患儿随机分为对照组和观察组。其中对照组30例,采用综合治疗、肺表面活性物质(PS)替代疗法及氧疗等常规治疗;观察组30例,在常规治疗基础上加用NO吸入(iN-O)治疗,NO与机械通气同步使用,吸入浓度从10 ppm开始,最高不超过30 ppm,平均气道压力为(12.7±2.7)cmH2O(1 cm H2O=0.098 kPa)。动态观察NO吸入前、后30～60 min及12～24 h体循环氧合变化、氧合指数(PaO2/FiO2)、肺泡气-动脉血氧分压差[P(A-a)O2],并动态作平均肺动脉血流速度(MPBFV)、心输出量(CO)、血压及心率的测定。结果观察组总有效率为93.33%;对照组总有效率为70.00%,两组比较,差异有统计学意义(χ2=5.04,P<0.05);早产儿吸入NO 5 min后PaO2明显上升,上升值为11%～29%,30 min后肺动脉压、PaO2/FiO2下降,MPBFV显著上升,差异均有高度统计学意义(均P<0.01),12～24 h后氧合持续稳定,吸入NO时NO2浓度监测均<1×10-6。结论 NO吸入能扩张肺血管,改善肺功能,在保证有效通气及良好心功能时为有前景的治疗手段。Objective To study the inhaled nitric oxide（NO） on the influence of lung function of premature.Methods 60 cases of clinical data admitted to neonatal respiratory distress syndrome（NRDS） from February 2008 to February 2012 in our hospital were chosen and randomly divided into two groups,30 cases in control group were treated with the comprehensive treatment,pulmonary surfactant（PS） replacement therapy and oxygen therapy;30 patients in observation group were treated with suction NO（iNO） therapy combined with conventional treatment,NO and mechanical ventilation were used synchronously,the suction concentration was 10-30 ppm,the average airway pressure was（12.7±2.7） cm H2O.Systemic oxygenation changes,oxygenation index（PaO2 /FiO2）,alveolar air-arterial blood oxygen partial pressure difference [P（A-a）O2],mean pulmonary artery blood flow velocity（MPBFV）,cardiac output（CO）,blood pressure and heart rate were dynamically observed and measured before and after 30-60 minutes and 12-24 hours.Results Total effectiveness in observation group and control group were 93.33% and 70.0%,the differences between the two groups were statistically significant（χ2= 5.04,P 0.05）;PaO2 was found rise NO suction 5 min later,the value was 11%～29%;pulmonary artery pressure,PaO2 /FiO2 were found decreased and the MPBFV was found rise,the differences were all statistically significant（all P 0.01）;the oxygenation was found continuously stable 12-24 hours later,concentration of NO2 was lower than 1×10-6 when NO was being sucked.Conclusion NO suction can expand pulmonary vascular,improve lung function,ensure effective ventilation and good heart function as a promising treatment.

关 键 词：一氧化氮 早产儿 肺功能 影响 

分 类 号：R722.1[医药卫生—儿科]