摘要
目的探讨吸入一氧化氮（NO）对新生儿持续肺动脉高压（PPHN）的治疗效果。方法对20例临床诊断PPHN的患儿进行NO吸入治疗,入院后经高频振荡机械通气呼吸支持,应用NO前呼吸机吸入氧浓度（FiO2）为（0.91±0.12）,气道压力（MAP）为（1.31±0.21）kPa,入院4～24h在呼吸机支持同时加NO吸入治疗。NO吸入前、后0.5h、6h、12h、24h、48h动态观察经皮血氧饱和度（SpO2）、血气动脉血氧分压（PaO2）、MAP、氧合指数（OI）、心率（HR）、血压（BP）的测定。结果患儿吸入NO治疗48h内经皮SpO2明显上升,OI、MAP明显下降（P〈0.05）,PaO2明显上升（P〈0.05）,而HR、BP无明显变化（P〉0.05）。24～48h后经皮SpO2持续稳定。治愈18例,2例死于严重并发症,吸入NO时二氧化氮（NO2）浓度监测均〈2ppm。结论 NO吸入能选择性扩张肺血管,改善氧合,对心血管无明显不良反应,在保证有效通气及良好灌注时为有效的治疗PPHN的手段。
Objective To study the therapeutic efficacy of inhaling nitric oxide（NO）for treating newborns with persistent pulmonary hypertension（PPHN）. Methods Twenty neonates diagnosed of PPHN received NO inhaling.High frequency oscillatory mechanical ventilation was used after neonates were admitted to hospital.Before use of NO inhaling,ventilator oxygen concentration（FiO2）was regulated at（0.91 ±0.12）and mean airway pressure（MAP）was（1.31±0.21）kPa.NO inhalation was added at meantime high frequency oscillatory ventilation therapy was performed 4～24hours after neonates were admitted to hospital.Percutaneous oxygen saturation（SpO2）,arterial partial pressure of oxygen（PaO2）of blood gas,MAP,oxygenation index（OI）,blood pressure（BP）and heart rate（HR）were measured at baseline,0.5h,6h,12 h,24hand 48 h after NO therapy. Results Following 48-hour inhalation of NO,percutaneous SpO2 elevated significantly,OI and MAP decreased significantly（P〈0.05）,PaO2 elevated significantly（P〈0.05）,whereas HR and BP did not change（P〉0.05）.Sustained improvements in SpO2 were noticed within 24～48hours of NO therapy.Eighteen neonates cured and 2died from severe complications,which the monitoring NO2 concentration was all〈2ppm while NO inhalation. Conclusion This preliminary clinical experience suggests that NO inhalation may be an effective therapy for PPHN,which can selectivelly enlarge pulmonary vessels,improve oxygenation,without adverse reaction,guarantee adequate ventilation and good perfusion.
出处
《右江民族医学院学报》
2015年第1期88-89,91,共3页
Journal of Youjiang Medical University for Nationalities
关键词
婴儿
新生
高血压
肺性
一氧化氮
吸入法
infant
newborn
hypertension
pulmonary
nitric oxide
inhalation
