摘要
目的探讨机械通气联合西地那非用于新生儿持续性肺动脉高压(PPHN)治疗的临床效果及对相关指标的影响。方法收集2016年8月至2018年8月在南京中医药大学徐州中心医院儿科接受治疗的68例PPHN患儿,分为对照组(n=34)和观察组(n=34),对照组在常规治疗基础上给予机械通气+硫酸镁治疗,观察组在常规治疗的基础上给予机械通气+西地那非治疗,观察2组血浆细胞因子水平、血流动力学指标变化情况等。结果观察组平均吸氧时间、住院时间均显著短于对照组(t=7.946、10.307,P <0.05);与对照组比较,治疗后观察组收缩期肺动脉压、肺动脉压力、肺血管阻力、体血管阻力水平均显著减低(t=11.579、24.081、6.735、2.946,P均<0.05),体循环收缩压显著升高(t=11.579、5.931,P <0.05);观察组治疗后B型尿钠肽、内皮素1、肿瘤坏死因子α及白介素8均显著低于对照组(t=34.744、6.886、15.873、11.036,P均<0.05),血管紧张素1显著高于对照组(t=5.931,P <0.05);观察组治疗总有效率高于对照组[97.06%(33/34)vs 82.35%(28/34),χ^2=5.100,P=0.023]、并发症总发生率低于对照组[8.82%(3/34) vs 29.41%(10/34),χ^2=4.660,P=0.030]。结论常频机械通气联合西地那非治疗PPHN患儿,可使患儿血流动力学、血浆细胞因子获得更好调节,能够明显效提高总体治疗效果。
Objective To evaluate the clinical effects of mechanical ventilation combined with sildenafil in the treatment of persistent pulmonary hypertension(PPHN) in newborns and its influence on related indicators. Methods Sixty-eight neonates with PPHN who were admitted to our hospital from August 2016 to August 2018 were divided into either a control group(n=34) or an observation group(n=34). The control group was given mechanical ventilation + magnesium sulfate treatment, and the observation group was given mechanical ventilation + sildenafil treatment. The changes of plasma cytokines and hemodynamics were observed. Results After treatment, the average oxygen inhalation time and hospitalization time in the observation group were significantly shorter than those in the control group(t=7.946 and 10.307, respectively, P < 0.05). Compared with the control group, the levels of systolic pulmonary artery pressure, pulmonary atresia, pulmonary vascular resistance, and systemic vascular resistance after treatment in the observation group were significantly lower than those in the control group(t=11.579, 24.081, 6.735, and 2.946, respectively, P < 0.05). Regarding blood pressure indicators, systolic pulmonary artery pressure was significantly lower and systolic blood pressure was significantly higher in the observation group(t=11.579 and 5.931, respectively P < 0.05). With regard to plasma cytokines, brain natriuretic peptide, endothelin,tumor necrosis factor-α, and interleukin-8 were significantly lower and angiotensin-1 was significantly higher in the observation group than in the control group(t=34.744, 6.886, 15.873, 11.036, and 5.710, respectively, P < 0.05). The total effective rate was significantly higher and the incidence of overall complications was significantly lower in the observation group than in the control group [97.06%(33/34) vs 82.35%(28/34), 8.82%(3/34) vs 29.41%(10/34);χ^2=5.100 and 4.660, respectively;P < 0.05]. Conclusion Normal frequency mechanical ventilation combined with sildenafil can better regulate the hemodynamics and plasma cytokines and significantly improve the overall therapeutic effect in neonates with PPHN.
作者
王彦波
李敏
金宝
王云
陈洋
吴杰斌
刘枭
周彬
Wang Yanbo;Li Min;Jin Bao;WangYun;Chen Yang;Wu Jiebin;Liu Xiao;Zhou Bin(Department of Pediatrics,Xuzhou Clinical School of Xuzhou Medical University,Xuzhou Central Hospital Affiliated to Nanjing University of Chinese Medicine,Xuzhou 221009,China)
出处
《中华临床医师杂志（电子版）》
CAS
2019年第9期659-663,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
江苏省妇幼健康重点学科项目(F201752)
关键词
高血压
肺性
通气机
机械
血流动力学
细胞因子类
Hypertension, pulmonary
Ventilators, mechanical
Hemodynamics
Cytokines
