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目的评价常频机械通气联合西地那非治疗新生儿持续肺动脉高压的疗效及安全性。方法 48例持续肺动脉高压新生儿随机分为2组,对照组23例给予常频通气等常规治疗;治疗组25例在对照组治疗基础上给予枸橼酸西地那非片0.5~2.0mg/(kg·次)鼻饲,1次/6h,直至撤机。结果治疗组肺动脉压力和肺动脉/体循环收缩压比值在治疗后逐步下降(P<0.05);治疗后2组pa(O2)和氧合指数与治疗前比较差异有统计学意义(P<0.05);2组上机时间、氧暴露时间及住院时间比较差异均有统计学意义(P<0.05),病死率、气胸和颅内出血发生率比较差异无统计学意义(P>0.05)。结论常频通气联合西地那非治疗新生儿持续肺动脉高压疗效确切,且不增加主要并发症的发生率。
Objective To evaluate the efficacy and safety of continuous-frequency mechanical ventilation plus sildenafil in the treatment of persistent pulmonary hypertension in newborns. Methods Forty-eight neonates with persistent pulmonary hypertension were randomly divided into two groups. The control group (n = 23) was given conventional therapy such as frequent ventilation. The treatment group (n = 25) received sildenafil citrate 0.5-2.0 mg / (kg · times) nasal feeding, 1 / 6h, until weaning. Results The pulmonary artery pressure and pulmonary artery / systemic systolic pressure ratio decreased gradually in the treatment group (P <0.05). After treatment, the Pa (O2) and oxygenation index in the two groups were significantly different from those before treatment (P <0.05). There were significant differences in the up time, oxygen exposure time and hospital stay between the two groups (P <0.05). There was no significant difference in mortality, pneumothorax and intracranial hemorrhage (P> 0.05). Conclusions Frequent pulmonary ventilation and sildenafil are effective in treating persistent pulmonary hypertension in neonates without increasing the incidence of major complications.