机械通气吸入一氧化氮对新生儿持续性肺动脉高压的影响

中国小儿急救医学 Pub Date : 2019-09-20 DOI:10.3760/CMA.J.ISSN.1673-4912.2019.09.010

Y. Wan, Shuqing Zhang, Dongmei Yue

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引用次数: 0

摘要

目的探讨吸入一氧化氮（iNO）联合机械通气治疗新生儿持续性肺动脉高压（PPHN）的临床疗效。方法对40例常规治疗效果不佳的PPHN新生儿进行iNO治疗。观察iNO前后不同时间点的肺动脉压、血气离子分析及呼吸功能变化。结果iNO治疗后肺动脉压由（54.95±17.08）mmHg（1mmHg=0.133kPa）迅速下降至（20.40±14.26）mmHg。40例患者在iNO治疗前0.5～1h内氧合改善，平均气道压（MAP）由（13.98±2.40）cmH2O（1cmH2O=0.098kPa）下降至（12.44±2.69）cmH2O，氧合指数（OI）从26.89±18.62下降到13.84±5.52，PaO2/FiO2从（60.34±23.49）mmHg上升到（144.46±23.49，结论机械通气联合iNO治疗PPHN能迅速改善新生儿氧合状态，降低肺血管阻力，提高生存率和远期预后。关键词：机械通风；吸入一氧化氮；新生儿持续性肺动脉高压

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Effect of inhaled nitric oxide with mechanical ventilation in persistent pulmonary hypertension of newborn

Objective To study the clinical effect of inhaled nitric oxide(iNO) with mechanical ventilation for the neonates with persistent pulmonary hypertension of newborn(PPHN). Methods A total of 40 neonates with PPHN poorly responding with routine treatment were treated with iNO therapy.Pulmonary artery pressure, blood gas ion analysis and respiratory function changes were observed at different time points before and after iNO. Results Treatment with iNO resulted in a rapid decrease in pulmonary artery pressure from(54.95±17.08) mmHg(1 mmHg=0.133 kPa) to(20.40±14.26) mmHg.Oxygenation of 40 cases improved in the first 0.5~1 hour after iNO therapy, the values of mean airway pressure(MAP)declined from(13.98±2.40)cmH2O(1 cmH2O=0.098 kPa) to(12.44±2.69)cmH2O, oxygenation index(OI)decreased from 26.89±18.62 to 13.84±5.52, PaO2/FiO2 increased from(60.34±23.49) mmHg to(144.46±23.49) mmHg, and the value of pH increased from 7.31±0.14 to 7.37±0.07.Furthermore, within 48 hours after treatment, PaO2/FiO2 and pH increased gradually, while MAP and OI decreased gradually, which all had statistical differences(P<0.01). Conclusion Mechanical ventilation combined with iNO therapy in the treatment of PPHN can rapidly improve the oxygenation status of neonates, reduce pulmonary vascular resistance, and then improve the survival rate and long-term prognosis. Key words: Mechanical ventilation; Inhaled nitric oxide; Persistent pulmonary hypertension of newborn

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来源期刊

中国小儿急救医学

自引率

0.00%

发文量

6226

期刊介绍： Chinese Journal of Neurology was established in 1955, the predecessor of which is Chinese Journal of Neurology and Psychiatry. Chinese Journal of Neurology and Psychiatry has been indexed by MEDLINE until 1996, when it was divided into two journals, Chinese Journal of Neurology, and Chinese Journal of Psychiatry. Chinese Journal of Neurology is now indexed by EM, SCOPUS, AJ, WPRIM, CNKI, Wanfang Data, CSCD, etc. The impact factor of the journal is 2.755 in 2017, ranking the first among all neurological and psychological journals in China and among all the 142 medical journals published by the Chinese Medical Association. The journal is available both in print and online.