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目的观察西地那非联合前列腺素类药物治疗小儿继发性肺动脉高压的临床效果。方法选择本院2012年1月—2015年1月收治的72例继发性肺动脉高压患儿,按随机数字表法分为对照组(36例)与观察组(36例)。两组患儿均给予常规治疗,对照组患儿给予前列地尔200μg加入250 ml 5%葡萄糖注射液,静脉滴注,1次/d。观察组同时给予西地那非0.35mg/kg,经鼻饲管胃药给药,1次/d。两组患儿均连续治疗6 d。统计两组患者治疗前后动脉氧合指数(oxygen index,OI)、Pa O2及肺动脉压(pulmonary arterial pressure,PAP),观察两组治疗效果及不良反应发生情况。计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果治疗期间,两组患儿均未出现严重不良反应;治疗后观察组患儿OI、Pa O2及PAP[(8.2±3.6)、(75.6±9.3)、(23.4±6.8)mm Hg(1 mm Hg=0.133k Pa)]均优于对照组[(13.7±4.3)、(63.5±8.1)、(35.4±9.6)mm Hg],对比差异均有统计学意义(均P<0.05)。观察组治疗总有效率较对照组高(94.4%、77.8%),两组比较差异有统计学意义(P<0.05)。结论西地那非联合前列腺素类药物治疗小儿继发性肺动脉高压能有效改善患儿动脉血气情况,降低PAP,疗效安全可靠。
Objective To observe the clinical efficacy of sildenafil combined with prostanoids in the treatment of children with secondary pulmonary hypertension. Methods Seventy-two children with pulmonary hypertension who were admitted to our hospital from January 2012 to January 2015 were randomly divided into control group (36 cases) and observation group (36 cases). Two groups of children were given conventional treatment, control group children given alprostadil 200μg 250ml 5% glucose injection, intravenous infusion, 1 / d. Observation group were given sildenafil 0.35mg / kg, nasogastric feeding stomach, 1 / d. Two groups of children were treated for 6 days. The arterial oxygen index (OI), Pa O2 and pulmonary arterial pressure (PAP) were measured before and after treatment in both groups. The therapeutic effects and adverse reactions of the two groups were observed. Measurement data using t test, count data using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results During the treatment, no serious adverse reactions occurred in both groups. OI, Pa O2 and PAP [(8.2 ± 3.6), (75.6 ± 9.3) and (23.4 ± 6.8) mm Hg Hg = 0.133kPa)] were significantly higher than those in the control group [(13.7 ± 4.3), (63.5 ± 8.1) and (35.4 ± 9.6) mm Hg, respectively), with significant difference (all P <0.05). The total effective rate of observation group was higher than that of control group (94.4%, 77.8%), the difference between the two groups was statistically significant (P <0.05). Conclusion Sildenafil combined prostaglandin drugs in children with secondary pulmonary hypertension can effectively improve the situation of children with arterial blood gas, reduce PAP, the effect of safe and reliable.