低浓度吸入一氧化氮治疗新生儿肺动脉高压的临床疗效及安全性  

Efficacy and safety of low-concentration inhalation of nitric oxide for persistent pulmonary hypertension of newborns

作　　者：刘学丹[1] 李晓春[1] 

机构地区：[1]安徽医科大学附属安庆医院儿科,安徽安庆246003

出　　处：《实用临床医药杂志》2016年第11期91-93,98,共4页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11525745)

摘　　要：目的探讨低浓度吸入一氧化氮(NO)治疗新生儿肺动脉高压(PPHN)的疗效及安全性。方法 63例PPHN患儿随机分为低浓度组21例、高浓度组21例及对照组21例。治疗前及治疗4 h后,分别检测各组氧分压[p(O2)]、二氧化碳分压[p(CO2)]、肺动脉压力(SPAP)及动脉血氧饱和度(Sa O2);治疗前后,分别对高、低浓度组凝血功能进行检测,包括凝血酶时间(PT)、活化部分凝血酶时间(APTT)和血小板计数(PLT);观察各组预后情况。结果吸入NO 4 h后,高、低浓度组患儿p(O2)、Sa O2明显高于对照组(P<0.01),p(CO2)及SPAP明显低于对照组(P<0.01),而高、低浓度组无显著差异(P>0.05)。高浓度组治疗后PT、APTT显著高于治疗前及低浓度组(P<0.05),2组PLT比较无显著差异(P>0.05)。高、低浓度组疗效均显著高于对照组(P<0.05),2组比较无显著差异(P>0.05)。结论不同浓度NO吸入治疗效果无明显差异,而低浓度吸入NO对凝血因子影响更小,疗效更安全。Objective To explore the efficacy and safety of low-concentration inhalation of nitric oxide（ NO） for persistent pulmonary hypertension of newborns（ PPHN）. Methods Sixtythree neonates with PPHN were randomly divided into low-concentration group（ n = 21）,high-concentration group（ n = 21） and control group（ n = 21）. Partial pressure of oxygen [p（ O2） ],partial pressure of carbon dioxide [p（ CO2） ],pulmonary arterial pressure（ SPAP） and arterial oxygen saturation（ Sa O2） were detected respectively in each group before and 4 h after treatment. The coagulation function,including thrombin time（ PT）,activated partial thromboplastin time（ APTT） and platelet（ PLT）,was detected in high and low-concentration groups before and after treatment,and the prognostic condition was observed in each group. Results Four hours after inhalation of NO,both p（ O2） and Sa O2 were markedly higher,and p（ CO2） and SPAP were notably lower in high and low-concentration groups than in control group（ P〈0. 01）,but there was no statistical significance between high and low-concentration groups（ P〉0. 05）. After treatment,PT and APTT in high-concentration group were dramatically higher than those before treatment and low-concentration group（ P〉0. 05）,but no significant difference was shown by comparison to PLT（ P〉0. 05）. The efficacy in high and low-concentration groups was significantly higher than that in control group（ P〈0. 05）,but there was no statistical significance between two groups（ P〉0. 05）. Conclusion Different-concentration inhalation of NO doesn＇ t affect the therapeutic effect. Low-concentration inhalation of NO has little influence on clotting factors and higher safety.

关 键 词：新生儿肺动脉高血压 一氧化氮 血气分析 凝血功能 

分 类 号：R722[医药卫生—儿科]