早期联合应用外源性PS和iNO治疗PPHN的效果  

Effect of early combined application of exogenous PS and iNO in the treatment of PPHN

作　　者：赵艳梅[1] 曹孟宸 王颍源[1] 郭静[1] 康文清[1] ZHAO Yanmei;CAO Mengchen;WANG Yingyuan;GUO Jing;KANG Wenqing(NICU,Children's Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属儿童医院NICU,河南郑州450000

出　　处：《临床医学研究与实践》2024年第8期81-84,共4页Clinical Research and Practice

摘　　要：目的探讨早期联合应用外源性肺表面活性物质(PS)和吸入一氧化氮(iNO)治疗新生儿持续性肺动脉高压(PPHN)的效果。方法选取2019年1月1日至2021年12月31日收治的100例PPHN患儿为研究对象,按照随机数字表法将其分成对照组和观察组,各50例。对照组应用iNO+安慰剂(空气),观察组应用iNO+外源性PS。比较两组的治疗效果。结果治疗前,两组的肺动脉收缩压(PASP)、氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、pH及氧合指数(OI)比较,差异无统计学意义(P>0.05);治疗24、48 h后,两组的PASP、PaCO_(2)、OI均降低,PaO_(2)及pH均升高,且观察组优于对照组,差异具有统计学意义(P<0.05)。观察组的治愈率明显高于对照组,应用体外氧合膜肺(ECMO)及死亡率低于对照组,呼吸机使用时间及总住院时间短于对照组,差异具有统计学意义(P<0.05);两组的不良反应发生情况比较,差异无统计学意义(P>0.05)。结论早期联合应用外源性PS和iNO可明显改善PPHN患儿的氧合情况、降低PASP,减少呼吸机使用时间、总住院时间、对ECMO需求及死亡率,值得临床推广应用。Objective To investigate the effect of early combined application of exogenous pulmonary surfactant(PS)and inhaled nitric oxide(iNO)in the treatment of persistent pulmonary hypertension of the newborn(PPHN)in neonates.Methods A total of 100 cases of PPHN admitted from January 1,2019 to December 31,2021 were selected as the research objects and divided into control group and observation group according to the random number table method,with 50 cases in each group.The control group was treated with iNO+placebo(air),and the observation group was treated with iNO+exogenous PS.The therapeutic effects of the two groups were compared.Results Before treatment,there were no significant differences in pulmonary artery systolic pressure(PASP),partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),pH and oxygenation index(OI)between the two groups(P>0.05);after 24,48 h of treatment,the PASP,PaCO_(2) and OI of the two groups decreased,PaO_(2) and pH increased,those in the observation group were better than the control group,and the differences were statistically significant(P<0.05).The cure rate of the observation group was significantly higher than that of the control group,the rate of application of extracorporeal membrane oxygenation(ECMO)and death were lower than those of the control group,the ventilator use time and hospitalization time were shorter than those of the control group,and the differences were statistically significant(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Early combined application of exogenous PS and iNO can significantly improve oxygenation,reduce PASP,reduce ventilator use time,hospitalization time,ECMO demand and mortality in children with PPHN,which is worthy of clinical promotion and application.

关 键 词：肺表面活性物质 吸入一氧化氮 新生儿持续性肺动脉高压 

分 类 号：R722.1[医药卫生—儿科]