NO治疗新生儿持续肺动脉高压.pdfVIP

682 Tianjin Med J, Jul 2012, Vol 40 No 7 doi: 10.3969/j .issn.但53-9896却12.创刷3 NO治疗新生儿持续肺动脉高压* 孙夫强段洋王林 摘要 目的:探讨吸入一氧化氮(iNO)联合高频振荡通气(HFOV)治疗新生儿持续性肺动脉高压(PPHN)的有效性 和安全性。方法:选取PPHN患儿36例，其中无器质性心脏病30倒(1组)，有先天性心脏病6倒(n组) ;对所有患儿进 行HFOV和iNO联合治疗。监测NO吸人前、吸入3如Omin及24h后萨的J氧合指数(ω01) 、平均压 平均气道压(MAP的)、动脉导管前后的经皮血氧饱和度(TcSa:础O2 ) ，吸入N03如Omi阳n及24h后测定高铁血红蛋白(Me创t旧Hbω)与 NOαz浓度。结果: 1 组，与吸入前比较，吸入30min和24h后，MAP、01和 SPAP均下降，导管前TcSa02和导管后TcSa02 升高，心率在吸入24h后下降，差异有统计学意义(p 0.01) 0 n组，吸入前后所有的检测指标差异均无统计学意义 (p 0.05)。治愈26例，死亡4例，放弃治疗6例。本组治疗期间，MetHb和 N02浓度均在正常范围。结论:肺血管痊孪 型PPHN患儿应尽早采用最低有效剂量iNO联合HFOV治疗。特别是;;æ. 34周早产PPHN患儿疗效更佳。 关键词一氧化氮高频通气高血压，肺性婴儿，新生 Nitric Oxide Therapy in.Persistent Pulmonary Hypertension of Newbom SUN Fuqia:ng , DUAN Yang, W ANG Lin The Second Hospital ofTianjin Medical Universi纱• Tianjin 3ω1211， China Abstract Objective: To study the therapeutic effects and safety of inhaled nitric oxide (iNO) a:nd high-frequency oscil- latory ventilation in neonatal persistent pulmona:ry hypertension (PPHN). Methods: Thirty-唱ix neonates wi由 PPHN were se- lected in this study including 30 without structural h由此 diseωe (group 1 ) a:nd 6 with congenital hea:rt disease (group n). ηle combined treatment of HFPV a:nd iNO wωused in all neonates. The values of oxygenation index (01), mean blωd pres- sure, systolic pulmonary a:rte可 pressure (SP Ap), hea:rt rate, mean airway pressure (MAP) a:nd saturation of bl∞d oxygen per cutemσcSa02) were detected before NO inhalation, after 30 min of NO inhalation and 24 h after inhalation. The values of me- thaemoglobin (MetHb) a:nd nitrogen dioxide (N02) concentration were monitored 30 min a:nd 24 h after NO inhalation. Re- sults: In group 1 , levels of MAP, 01 a:nd SPAP decreased significa:ntly 30 min a:nd 24 h after inhalation. The level of TcSa0 2 was increased si伊ificantly， and hea:rt rate wωdecreωed significantly 24 h after inhalation (P 0.01). In group n, there were nosiF迫cant changes before and 础.er NO inhalation (P 0.05). In this study, 26 neonates survived