西地那非联合肺表面活性物质治疗胎粪吸入综合征伴持续肺动脉高压患儿临床疗效

目的 观察西地那非联合肺表面活性物质对新生儿胎粪吸入综合征（MAS）伴持续肺动脉高压（PPH）的治疗效果.方法 收集我院自2012-06～2013-05收治的MAS伴PPH住院患儿92例,按随机数字表格法分为两组,每组46例,两组均进行呼吸道清理、高频振荡辅助通气、合适补液、抗生素等常规治疗,对照组46例患儿加用猪肺表面活性物质,观察组46例患儿在对照组基础上加用西地那非. 结果 观察组患儿治疗后4,12,36 h的氧合指数、肺泡-动脉氧分压差值均明显低于同期对照组（均P ＜0.05）;治疗36 h后,观察组与对照组患儿肺动脉压分别为（40.3±11.1） mmHg和（49.2±12.8）mmHg,两组比较差异具有统计学意义（t=2.836,P＜0.05）. 结论 西地那非联合肺表面活性物质,能进一步改善对新生儿MAS伴PPH的氧合及肺动脉压.

Clinical efficacy of sildenafil combined with pulmonary surfactant in treatment of meconium aspiration syndrome

Objective To explore the clinical efficacy of sildenafil combined with pulmonary surfactant in treatment of meconium aspiration syndrome combined with persistence pulmonary hypertension（PPH）.Methods Ninety-two cases of meconium aspiration syndrome （MAS） combined with PPH hospitalized in department of pediatrics in Maternal and Child Health Hospital from June 2012 to May 2013 were randomly divided into two groups （46 cases in each group）.All the patients underwent respiratory clean,high-frequency oscillation assisted ventilation,proper rehydration,antibiotics and other conventional treatment.The patients were given pulmonary surfactant in control group,and additionally sildenafil in observation group.Results The values of oxygenation index,alveolar-arterial oxygen of patients in observation group after treatment for 4,12,36 h were significantly lower than in control group （all P ＜ 0.05）.The pulmonary arterial pressure was （40.3 ± 11.1） mmHg in control group and （49.2 ± 12.8） mmHg in observation group after 36 h,and the difference was statistically significant （t =2.836,P ＜ 0.05）.Conclusion Sildenafil combined with pulmonary surfactant can further improve the oxygenation and pulmonary artery pressure in the newborn MAS combined with PPH.