不同机械通气方案联合多巴酚丁胺治疗新生儿持续肺动脉高压的临床效果对比  

Clinical Comparison of Different Mechanical Ventilation Schemes Combined with Dobutamine in the Treatment of Persistent Pulmonary Hypertension of the Newborn

作　　者：张姗姗[1] 丁婧[1] 秦好奇 张茜[1] ZHANG Shanshan;DING Jing;QIN Haoqi;ZHANG Qian(Neonatal Intensive Care Ward(2),the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院新生儿重症监护病区(2),河南郑州450000

出　　处：《河南医学研究》2024年第17期3140-3142,共3页Henan Medical Research

摘　　要：目的对比新生儿持续性肺动脉高压(PPHN)患儿应用不同机械通气方案联合多巴酚丁胺治疗的临床效果。方法选取2019年1月至2022年12月郑州大学第一附属医院收治的82例PPHN患儿,利用计算机生成的随机数字分成两组,每组41例。两组均接受常规治疗,对照组接受常频机械通气联合多巴酚丁胺治疗,观察组接受高频振荡通气联合多巴酚丁胺治疗,两组均治疗2 d。对比两组临床疗效、血气分析指标以及相关血清指标[氨基末端脑钠肽前体(NT-proBNP)与肌酸激酶同工酶(CK-MB)]。结果观察组总有效率高于对照组(P<0.05)。两组患儿治疗2 d后动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))升高,动脉血二氧化碳分压(PaCO_(2))下降,且观察组PaO_(2)、SaO_(2)高于对照组,PaCO_(2)低于对照组(P<0.05)。两组患儿治疗2 d后NT-proBNP、CK-MB水平降低,且观察组NT-proBNP、CK-MB水平低于对照组(P<0.05)。结论将高频振荡通气与多巴酚丁胺联合应用于PPHN患儿治疗中效果显著,可改善血气分析指标,减轻心肌损伤。Objective To compare the clinical effect of different mechanical ventilation schemes combined with dobutamine in persistent pulmonary hypertension of the newborn(PPHN).Methods A total of 82 neonates with PPHN treated in the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2022 were selected,using computer-generated random numbers to divide them into two groups,with 41 cases in each group.Both groups received routine treatment,the control group was treated with normal frequency mechanical ventilation combined with dobutamine,and the observation group was treated with high frequency oscillatory ventilation combined with dobutamine,both groups were treated for 2 days.The clinical efficacy,blood gas analysis indexes and related serum indexes[N-terminal pro-brain natriuretic peptide(NT-proBNP)and creatine kinase isoenzymes(CK-MB)]were compared between the two groups.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).The arterial partial pressure of oxygen(PaO_(2))and arterial oxygen saturation(SaO_(2))of patients in both groups were increased and arterial partial pressure of carbon dioxide(PaCO_(2))was decreased two days after treatment,and PaO_(2) and SaO_(2) in the observation group were higher than those in the control group,while PaCO_(2) was lower than that in the control group(P<0.05).Compared with before treatment,the NT-proBNP and CK-MB levels in the two groups of children decreased after 2 days of treatment,and the NT-proBNP and CK-MB levels in the observation group were lower than those in the control group(P<0.05).Conclusion High frequency oscillatory ventilation combined with dobutamine has definite efficacy in the treatment of PPHN,which can improve the indexes of blood gas analysis and reduce myocardial injury.

关 键 词：新生儿持续性肺动脉高压 机械通气 多巴酚丁胺 血气分析 

分 类 号：R722.19[医药卫生—儿科]