CAJ | 학술논문

目的：探讨气管内滴入一氧化氮供体硝普钠对新生儿持续性肺动脉高压（PPHN ）的治疗效果和安全性。方法对19例PPHN患儿在机械通气下予以硝普钠气管内滴入，分别于基础状态、气管内滴入硝普钠后30、60、120 min测量平均肺动脉压（PAMP）、平均动脉压（AMP）、右上肢及左下肢的经皮血氧饱和度（TcSaO2），并进行比较分析。结果19例PPHN患儿中，17例患儿原发疾病在肺部，其中82．35％（14/17）的患儿气管内滴入硝普钠后 PAMP明显降低，30 min时最明显[（21．30±4．20） mm Hg vs ．（30．30±4．20）mm Hg）]，与治疗前比较差异有统计学意义（P＜0．05）；但治疗前、后AMP[（56．00±3．00）mm Hg vs ．（55．00±6．00）mm Hg]比较，差异无统计学意义（P＞0．05）。2例PPHN继发于先天性心脏病者无效。结论气管内滴入硝普钠是治疗PPHN安全、有效且经济的方法。
목적：탐토기관내적입일양화담공체초보납대신생인지속성폐동맥고압（PPHN ）적치료효과화안전성。방법대19례PPHN환인재궤계통기하여이초보납기관내적입，분별우기출상태、기관내적입초보납후30、60、120 min측량평균폐동맥압（PAMP）、평균동맥압（AMP）、우상지급좌하지적경피혈양포화도（TcSaO2），병진행비교분석。결과19례PPHN환인중，17례환인원발질병재폐부，기중82．35％（14/17）적환인기관내적입초보납후 PAMP명현강저，30 min시최명현[（21．30±4．20） mm Hg vs ．（30．30±4．20）mm Hg）]，여치료전비교차이유통계학의의（P＜0．05）；단치료전、후AMP[（56．00±3．00）mm Hg vs ．（55．00±6．00）mm Hg]비교，차이무통계학의의（P＞0．05）。2례PPHN계발우선천성심장병자무효。결론기관내적입초보납시치료PPHN안전、유효차경제적방법。
Objective To investigate the therapeutic effect and safety of the intratracheal instillation of sodium nitroprusside for treating persistent pulmonary hypertension of newborn (PPHN) .Methods The intratracheal instillation of sodium nitroprusside was used to 19 cases of PPHN under the mechanical ventilation ,and the pulmonary arterial mean pressure(PAMP) ,arterial mean pressure(AMP) ,transcutaneous oxygen saturation(TcSaO2 ) of the right upper and left lower limb at the basic state ,30 ,60 ,120min after intratracheal instillation of sodium nitroprusside were respectively measured and compared .Results Among 19 cases of PPHN ,17 cases had the primary lung disease .Of 17 cases ,14 cases(82 .35% ) had significant decrease of PAMP after intratracheal instillation of sodium nitroprusside ,which was most significant at 30min after therapy and the difference was statistically significant compared with before therapy [(21 .30 ± 4 .200)mm Hg vs .(30 .30 ± 4 .20)mm Hg ,P<0 .05] ,but AMP between before and after therapy had no statistical difference [(56 .00 ± 3 .00)mm Hg vs .(55 .00 ± 6 .00)mm Hg ,P>0 .05] .Conclusion The intratracheal instillation of sodium nitroprusside is the safe ,effective and economic method for treating PPHN .