肝素钠辅助治疗新生儿持续性肺动脉高压50例临床疗效分析  

Analysis of Clinical Efficacy of Sodium Heparin-assisted Treatment of 50 Cases of Persistent Pulmonary Hypertension in Neonates

作　　者：宋丽艳 朱亚平 周旭晨[2] 谷强[1] SONG Li-yan;ZHU Ya-ping;ZHOU Xu-chen;GU Qiang(Department of Paediatrics,The First Affiliated Hospital of Shihezi University,Xinjiang Shihezi,832008;Department of Neonatology,the First Division Hospital of Xinjiang Production and Construction Corps,Xinjiang Aksu,843000)

机构地区：[1]石河子大学第一附属医院儿科,新疆石河子832008 [2]新疆生产建设兵团第一师医院新生儿科,新疆阿克苏843000

出　　处：《农垦医学》2024年第4期302-306,311,共6页Journal of Nongken Medicine

基　　金：国家自然科学基金(82360315)。

摘　　要：目的:探讨肝素钠辅助治疗新生儿持续性肺动脉高压(Peresistent Pulmonary Hypertension of the Newborn,PPHN)的疗效及其可能的作用。方法:选择2017年7月-2023年7月我科收治的PPHN患儿进行回顾性研究,按是否使用肝素钠治疗分为肝素组和非肝素组。非肝素组采用机械通气和血管活性药物等综合治疗,肝素组在此基础上静脉注射肝素钠(5~10U/kg/次,q8h,疗程3~5d)。比较两组治疗前后的血气分析、肺动脉压力(PAP)以及住院、机械通气和氧疗时间,分析肝素钠辅助治疗PPHN的疗效及可能的作用。结果:共纳入PPHN患儿112例,其中肝素组50例,非肝素组62例,两组在基础疾病及治疗前血气分析、PAP等差异均无统计学意义(P>0.05);治疗48h后肝素组PAP低于非肝素组,治疗24h、48h后肝素组FiO_(2)、PCO_(2)低于非肝素组,PO_(2)、SaO_(2)、PO_(2)/FiO_(2)高于非肝素组,氧疗时间缩短,差异均有统计学意义(P<0.05);肝素组呼吸机使用时间和住院时长与非肝素组比较,差异统计学意义(P<0.05)。结论:肝素钠辅助治疗可改善PPHN患儿低氧血症,缩短氧疗时间、呼吸机使用时间和住院时长。Objective:To investigate the therapeutic effect and possible effect of heparin sodium in the treatment of neonatal persistent pulmonary hypertension(PPHN).Methods:Children with PPHN admitted to our department from July 2017 to July 2023 were retrospectively studied and divided into heparin group and non-heparin group according to whether they were treated with heparin sodium or not.The non-heparin group was treated with mechanical ventilation and vasoactive drugs.On the basis of this,the heparin group was also give intravenous heparin sodium(5-10U/kg/time,q8h,treatment for 3-5 days).Blood gas analysis,pulmonary artery pressure(PAP),hospitalization,mechanical ventilation and oxygen therapy duration before and after treatment were compared between the two groups,and the efficacy and possible effects of heparin sodium in the adjuvant treatment of PPHN were analyzed.Results:A total of 112 children with PPHN were included,including 50 in the heparin group and 62 in the non-heparin group.There were no statistically significant differences between the two groups in underlying diseases,blood gas analysis and PAP before treatment(P>0.05).After 48 hours of treatment,PAP in heparin group was lower than that in non-heparin group,FiO_(2)and PCO_(2)in 24 and 48 hours of treatment in heparin group were lower than that in non-heparin group,PO_(2),SaO_(2)and PO_(2)/FiO_(2)were higher than that in non-heparin group,and oxygen therapy duration was shortened,with statistical significance(P<0.05).And,there was obviously significant difference in mechanical ventilation duration and hospitalization between heparin group and non-heparin group(P<0.05).Statistically significant differences in ventilator use and length of stay in the heparin group compared with the non-heparin group(P<0.05).Conclusion:Heparin sodium adjunctive therapy improves hypoxaemia in children with PPHN and reduces the duration of oxygen therapy,ventilator use and length of hospital stay.

关 键 词：肝素钠 PPHN 新生儿 临床疗效 

分 类 号：R722.1[医药卫生—儿科]