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目的探讨高频振荡通气(HFOV)联合西地那非治疗新生儿持续性肺动脉高压(PPHN)的疗效。方法 50例PPHN患儿分为HFOV组(A组,n=16)、HFOV联合低剂量西地那非组(B组,n=16)和HFOV联合高剂量西地那非组(C组,n=18),观察并比较3组治疗前及治疗3 d后肺动脉压(PAP)、动脉血氧分压(PaO2)、动脉血氧饱和度(SaO2)和动脉血CO2分压(PaCO2)。结果治疗前各组PAP、PaO2、SaO2及PaCO2比较差异均无统计学意义(P>0.05)。治疗后各组PAP较治疗前均显著下降,差异有统计学意义(P<0.05);各组PAP降幅比较差异均有统计学意义(P<0.05)。C组治疗有效率高于A组,差异有统计学意义(P<0.05)。治疗后各组PaO2、SaO2较治疗前升高,PaCO2下降,差异均有统计学意义(P<0.05)。B、C 2组PaO2和SaO2升高的幅度及PaCO2下降的幅度大于A组,差异有统计学意义(P<0.05)。C组SaO2升高的幅度和PaCO2下降的幅度大于B组,差异有统计学意义(P<0.05)。结论 HFOV联合西地那非治疗PPHN疗效较好。
Objective To investigate the effect of high frequency oscillatory ventilation (HFOV) combined with sildenafil on neonatal persistent pulmonary hypertension (PPHN). Methods Fifty children with PPHN were divided into HFOV group (group A, n = 16), HFOV combined with low dose sildenafil group (group B, n = 16) and HFOV combined with high dose sildenafil group (group C, n = 18). The pulmonary arterial pressure (PAP), PaO2, SaO2 and PaCO2 were observed before and 3 days after treatment. Results There were no significant differences in PAP, PaO2, SaO2 and PaCO2 before treatment (P> 0.05). After treatment, PAP in each group was significantly lower than that before treatment, the difference was statistically significant (P <0.05); PAP decline in each group were statistically significant (P <0.05). The effective rate of C group was higher than that of A group, the difference was statistically significant (P <0.05). After treatment, the PaO2 and SaO2 in each group increased compared with those before treatment, while the PaCO2 decreased. The differences were statistically significant (P <0.05). The increase of PaO2 and SaO2 and the decrease of PaCO2 in group B and group C were greater than that in group A, the difference was statistically significant (P <0.05). The increase of SaO2 and the decrease of PaCO2 in group C were greater than those in group B, the difference was statistically significant (P <0.05). Conclusion HFOV combined with sildenafil treatment of PPHN better.