论文部分内容阅读
目的观察枸橼酸西地那非及硫酸镁治疗新生儿持续性肺动脉高压(PPHN)的临床疗效及西地那非改善右心功能情况。方法将2011年6月至12月确诊为新生儿肺动脉高压50例患儿随机分成硫酸镁组25例与西地那非组25例,监测治疗前及治疗后体循环动脉压、肺动脉压力(PAP)、血气分析变化。对比观察应用硫酸镁组、西地那非组治疗前治疗不同时间段及治疗结束后,各指标变化情况。结果西地那非组与硫酸镁组有效率比较无显著差异(P>0.05)。2组应用呼吸机至有效标准的时间,西地那非组明显短于硫酸镁组(P<0.05)。与硫酸镁组相比,治疗后60min,西地那非组PAP降低较硫酸镁组明显(P<0.01)。治疗120min时2组血压差异显著(P<0.01)。西地那非组继续口服和治疗结束时PAP值仍持续下降,无反跳现象,且在治疗过程中体循环血压不受影响。西地那非组右室射血分数(RVEF)较治疗前增加(P<0.05)。结论应用西地那非治疗新生儿肺动脉高压效果明确,与硫酸镁治疗相比,操作简单,起效时间快,无不良血管事件,可有效缩短呼吸机应用时间,减少呼吸机相关并发症的发生,并从一定程度上改善右心功能。
Objective To observe the clinical efficacy of sildenafil citrate and magnesium sulfate in the treatment of neonatal persistent pulmonary hypertension (PPHN) and the improvement of right ventricular function in sildenafil. Methods A total of 25 children diagnosed as neonatal pulmonary hypertension from June 2011 to December 2011 were randomly divided into 25 cases of magnesium sulfate group and 25 cases of sildenafil group. The levels of systemic arterial pressure, pulmonary artery pressure (PAP) Blood gas analysis changes. Compare the application of magnesium sulfate group, sildenafil group before treatment for different time periods and after treatment, the changes of the indicators. Results Sildenafil group and magnesium sulfate group efficiency was no significant difference (P> 0.05). In the second group, the ventilator was used to a valid standard time, sildenafil group was significantly shorter than the magnesium sulfate group (P <0.05). Compared with magnesium sulfate group, the decrease of PAP in sildenafil group was significantly more than that of magnesium sulfate group (P <0.01) 60 minutes after treatment. There was a significant difference in blood pressure between the two groups at 120 min (P <0.01). PAP continued to decrease and rebound at the end of oral sildenafil and treatment, and systemic blood pressure was not affected during treatment. Right ventricular ejection fraction (RVEF) in sildenafil group was higher than that before treatment (P <0.05). Conclusion The application of sildenafil treatment of neonatal pulmonary hypertension clear effect, compared with magnesium sulfate treatment, simple operation, fast onset of time, no adverse vascular events, can effectively shorten the ventilator application time and reduce the occurrence of ventilator-related complications , And to a certain extent, improve right heart function.