HFOV叠加CMV联合西地那非、注射用牛肺表面活性剂治疗重度PPHN的效果  

Effect of HFOV plus CMV combined with Sildenafil andcalf pulmonary surfactant for injection on severe PPHN

作　　者：杨海娟[1] 许泽辉[1] 张梦华[2] YANG Hai-juan;XU Ze-hui;ZHANG Meng-hua(Department of Pediatric,Langfang People′s Hospital,Hebei Province,Langfang 065000,China;Department of Ultrasound,Langfang People′s Hospital,Hebei Province,Langfang 065000,China)

机构地区：[1]河北省廊坊市人民医院儿科,河北廊坊065000 [2]河北省廊坊市人民医院超声科,河北廊坊065000

出　　处：《河北医科大学学报》2020年第3期315-318,共4页Journal of Hebei Medical University

基　　金：廊坊市科学技术研究与发展计划(2016013180)。

摘　　要：目的探讨高频振荡通气(high frequency oscillatory ventilation,HFOV)叠加常频通气(constant frequency ventilation,CMV)联合西地那非、注射用牛肺表面活性剂治疗重度新生儿持续性肺动脉高压(persistent pulmonaryhypertension of newborn,PPHN)的临床效果。方法选取重度PPHN患儿86例,按照随机数字表法分为研究组和对照组各43例,对照组给予西地那非、CMV治疗,研究组给予HFOV叠加CMV联合西地那非,注射用牛肺表面活性剂治疗。比较2组患儿治疗前及治疗后6,12,24,36 h的氧合指数(oxygenation index,OI)、血氧饱和度(oxygen saturation of blood,SpO 2),治疗相关指标及治疗疗效。结果研究组治疗后各时点的OI明显低于对照组,研究组治疗后12,24,36 h的SpO 2明显高于对照组,差异有统计学意义(P<0.01)。各组治疗后不同时点的OI与治疗前比较明显降低,研究组治疗后各时点的SpO 2与治疗前比较明显升高,对照组治疗后36 h的SpO 2与治疗前比较明显升高,差异有统计学意义(P<0.01)。研究组的吸氧时间、呼吸机使用时间、住院时间、住院费用明显少于对照组,差异有统计学意义(P<0.01)。研究组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论HFOV叠加CMV联合西地那非,注射用牛肺表面活性剂治疗重度PPHN患儿,可有效改善肺氧合功能,减少呼吸机使用时间、氧疗时间,提高治疗疗效。Objective To investigate the clinical effects of high frequency oscillatory ventilation(HFOV)combined with normal frequency ventilation(CMV)combined with Sildenafil and colisulla on severe neonatal persistent pulmonary hypertension(PPHN).Methods A total of 86 children with severe PPHN were selected and divided into a study group and a control group with 43 cases each according to the random number table method.The control group was treated with sildenafil and CMV treatment.The oxygenation index(OI),oxygen saturation of blood(SpO 2),treatment-related indexes,and treatment efficacy were compared between patients of two groups before and 6 h,12 h,24 h,36 h after treatment.Results The OI of the study group was significantly lower than that of the control group at each time point after treatment.The SpO 2 at 12 h,24 h and 36 h after treatment was significantly higher in the study group than in the control group(P<0.01).The OI at different time points after treatment was significantly lower than that before treatment.The SpO 2 at each time point after treatment was significantly higher than that before treatment.The SpO 2 at 36 h after treatment was significantly higher than that before treatment with statistical significance(P<0.01).The oxygen inhalation time,ventilator use time,hospitalization time,and hospitalization cost of the study group were significantly lower than those of the control group,and the difference was statistically significant(P<0.01).The total effective rate of the study group was significantly higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion Sildenafil combined with calsurf and HFOV superimposed CMV in children with heavy negative PPHN can effectively improve pulmonary oxygenation,reduce ventilator use time,oxygen therapy time and improve treatment efficacy.

关 键 词：高血压 肺性 胸壁震荡通气 西地那非 

分 类 号：R544[医药卫生—心血管疾病]