高频振荡通气联合西地那非治疗新生儿重度肺动脉高压的临床研究

2006年1月至2012年12月在我科住院的60例持续肺动脉高压患儿,试验组32例,采用高频通气联合西地那非,对照组28例,采用单纯高频通气治疗,比较两组疗效.治疗后3d研究组与对照组肺动脉平均压分别为（32.4±5.7） mm Hg（1 mm Hg=0.133 kPa）比（43.1±8.6）mm Hg,二氧化碳分压分别为（35.8±8.6）mm Hg比（43.1±8.6） mm Hg,氧合指数分别为（55.8±21.8）比（85.3±20.6）（P＜0.05）,动脉氧分压分别为（88.9±14.6）mm Hg比（71.6±21.7） mm Hg,PaOJFiO2分别为（223.5±18.0）mm Hg比（196.1±24.1）mm Hg,均高于对照组（P＜0.05）.研究组上机时间短于对照组（P＜0.05）,总有效率高于对照组（P＜0.05）.高频通气联合西地那非治疗重度持续肺动脉高压可有效降低肺动脉压力,缩短上机时间,提高治愈率.

Effects of high-frequency oscillatory ventilation plus sildenafil in severe persistent pulmonary hypertension of newborns

A total of 60 infants with severe persistent pulmonary hypertension （PPHN） at our NICU from January 2006 to December 2012 were divided into research group（n =32,high-frequency oscillatory ventilation（HFOV） plus sildenafil）]and control group （n =28,HFOV only）.Mean pulmonary arterial pulmonary arterial （MPAP）,blood gas analysis,oxygenation index （OI）,PO2 to fraction of inspired oxygen ratio （PO2/FiO2） before and after treatment were compared between two groups.After 3-day treatment,MPAP （mm Hg）（32 ±6） vs.（43 ±9）mm Hg,PCO2（mm Hg）（36 ±9） vs.（43 ±9）,OI（56 ±22） vs.（85 ±21） in research group were significantly lower than those in control group（P ＜ 0.05） ; in comparison with control group,PO2（mm Hg） （89 ±15） vs.（72 ±22）,PO2/FiO2（mm Hg） （223 ± 18） vs.（196 ±24） in research group were significantly higher（P ＜ 0.05）.The time of ventilation use （d） （5.4 ± 1.3） vs.（6.3 ± 1.6） in research group was shorter than that of control group（P ＜0.05） while research group showed a higher clinical efficiency rate（％） （81.2 vs.50.0） （P ＜0.05）.A combination of HFOV and sildenafil for severe PPHN can significantly reduce MPAP,shorten the duration of ventilation use and improve cure rate.