一氧化氮吸入联合机械通气治疗对持续性肺动脉高压患儿临床效果、氧合指数及疾病转归的影响  

Effects of Inhaled Nitric Oxide Combined with Mechanical Ventilation on Clinical Efficacy,Oxygenation Index and Disease Prognosis in Treatment of Persistent Pulmonary Hypertension of the Newborn

作　　者：陈燕[1] 张翀[1] 庄园 周菁鑫 王利维 CHEN Yan;ZHANG Chong;ZHUANG Yuan;ZHOU Jing-xin;WANG Li-wei(Department of Neonatal Intensive Care Unit,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200092,China;Department of Neonatology,Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University,Shanghai 200092,China)

机构地区：[1]上海市交通大学医学院附属新华医院新生儿重症监护室,上海200092 [2]上海市交通大学医学院附属新华医院新生儿科,上海200092

出　　处：《解放军医药杂志》2021年第12期56-59,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：上海市科学技术委员会科研计划项目(150173435)。

摘　　要：目的分析一氧化氮吸入(iNO)联合机械通气治疗对新生儿持续性肺动脉高压(PPHN)的临床效果、氧合指数(OI)及疾病转归的影响。方法回顾性分析2014年3月—2020年5月收治的PPHN 98例的临床资料,按照治疗方式分为研究组和对照组,每组49例。对照组予常频机械通气治疗,研究组在对照组基础上联合iNO治疗。比较2组治疗效果;对比2组治疗前后动脉血气指标水平;观察2组治疗前后肺动脉收缩压(SPAP)、肺动脉平均压(PAMP)和肺动脉压(PAP)变化情况;比较2组氧疗时间、机械通气时间及住院时间;记录2组治疗结局。结果研究组总有效率高于对照组(P<0.05)。2组治疗后血氧饱和度、动脉血氧分压水平高于治疗前,吸入氧浓度、OI水平低于治疗前,且研究组变化幅度高于对照组(P<0.05)。2组治疗后SPAP、PAMP、PAP水平较治疗前下降,且研究组低于对照组(P<0.05)。研究组氧疗时间、机械通气时间及住院时间均短于对照组,病死率低于对照组(P<0.05,P<0.01)。结论iNO联合机械通气治疗PPHN临床效果佳,可显著缩短机械通气时间并改善OI,在提高动脉血气水平时控制PAP,更有利于疾病转归。Objective To analyze effects of inhaled nitric oxide(iNO)combined with mechanical ventilation on clinical efficacy,oxygenation index(OI)and disease prognosis of persistent pulmonary hypertension of the newborn(PPHN).Methods Clinical data of 98 patients with PPHN admitted between March 2014 and May 2020 was retrospectively analyzed.According to the different therapeutic methods,the patients were divided into research group and control group(n=49 in each group).Control group was treated with normal frequency mechanical ventilation,while research group was supplemented with iNO on the treatment for control group.The therapeutic effect was compared,and the arterial blood gas indexes before and after treatment were also compared between two groups.Changes of systolic pulmonary artery pressure(SPAP),mean pulmonary artery pressure(PAMP)and pulmonary artery pressure(PAP)were observed before and after treatment in two groups.Therapeutic time of oxygen therapy,duration of mechanical ventilation and length of stay were compared between two groups.The treatment outcomes were recorded in two groups.Results The total effective rate in research group was significantly higher than that in control group(P<0.05).After treatment,levels of blood oxygen saturation and arterial oxygen partial pressure were significantly higher,while levels of inhaled oxygen concentration and OI were significantly lower than those before treatment in two groups,and the change range in research group was more obvious than that in control group(P<0.05).After treatment,levels of SPAP,PAMP and PAP were significantly lower than those before treatment in two groups,and the levels in research group were significantly lower than those in control group(P<0.05).Compared with those in control group,therapeutic time of oxygen therapy,duration of mechanical ventilation and length of stay were significantly shorter,while the mortality was significantly lower in research group(P<0.05,P<0.01).Conclusion The iNO combined with mechanical ventilation in treatment of PPHN

关 键 词：持续性肺动脉高压 一氧化氮吸入 血氧饱和度 氧合指数 肺动脉收缩压 肺动脉平均压 

分 类 号：R722.1[医药卫生—儿科]