中华现代护理杂志
中華現代護理雜誌
중화현대호리잡지
CHINESE JOURNAL OF MODERN NURSING
2014年
10期
1221-1223
,共3页
新生儿%胎粪吸入综合征%肺动脉高压%西地那非%肺表面活性物质
新生兒%胎糞吸入綜閤徵%肺動脈高壓%西地那非%肺錶麵活性物質
신생인%태분흡입종합정%폐동맥고압%서지나비%폐표면활성물질
Newborn%Meconium aspiration syndrome%Pulmonary hypertension%Sildenafil%Pulmonary surfactant
目的：探讨西地那非联合肺表面活性物质（ PS）对新生儿胎粪吸入综合征（ NMAS）合并肺动脉高压（ PPH）患儿治疗效果，并总结护理经验。方法将60例NMAS合并PPH患儿按随机数字表法分为对照组和观察组各30例。两组均采用高频振荡辅助通气、合适补液、抗生素等进行常规治疗，对照组患儿接受气管内滴入PS，观察组在对照组的基础上加用西地那非；比较两组患者治疗前后的氧合指数与肺泡动脉氧分压差值及治疗后肺动脉压（ PAP）。结果治疗后4，12 h两组患者氧合指数（ OI）及肺泡动脉氧分压差（ A-aDO2）比较差异均有统计学意义（ P＜0．01）；治疗36 h后，观察组患儿 OI 为（11．7±2．8），对照组为（19．1±3．4），两组比较差异有统计学意义（t＝9．202，P＜0．01）；观察组A-aDO2为（12．1±3．2）mmHg，对照组为（27．6±5．5）mmHg，两组比较差异有统计学意义（t＝13．342，P＜0．01）。治疗24～36 h后，观察组与对照组PAP分别为（40．4±10．7） mmHg和（49．3±13．4） mmHg，两组比较差异具有统计学意义（t＝2．843，P＜0．01）。两组均无不良并发症发生。结论西地那非联合PS，同时做好呼吸道护理及高频振荡辅助通气时气道护理，能进一步提高对NMAS伴PPH的治疗效果。
目的：探討西地那非聯閤肺錶麵活性物質（ PS）對新生兒胎糞吸入綜閤徵（ NMAS）閤併肺動脈高壓（ PPH）患兒治療效果，併總結護理經驗。方法將60例NMAS閤併PPH患兒按隨機數字錶法分為對照組和觀察組各30例。兩組均採用高頻振盪輔助通氣、閤適補液、抗生素等進行常規治療，對照組患兒接受氣管內滴入PS，觀察組在對照組的基礎上加用西地那非；比較兩組患者治療前後的氧閤指數與肺泡動脈氧分壓差值及治療後肺動脈壓（ PAP）。結果治療後4，12 h兩組患者氧閤指數（ OI）及肺泡動脈氧分壓差（ A-aDO2）比較差異均有統計學意義（ P＜0．01）；治療36 h後，觀察組患兒 OI 為（11．7±2．8），對照組為（19．1±3．4），兩組比較差異有統計學意義（t＝9．202，P＜0．01）；觀察組A-aDO2為（12．1±3．2）mmHg，對照組為（27．6±5．5）mmHg，兩組比較差異有統計學意義（t＝13．342，P＜0．01）。治療24～36 h後，觀察組與對照組PAP分彆為（40．4±10．7） mmHg和（49．3±13．4） mmHg，兩組比較差異具有統計學意義（t＝2．843，P＜0．01）。兩組均無不良併髮癥髮生。結論西地那非聯閤PS，同時做好呼吸道護理及高頻振盪輔助通氣時氣道護理，能進一步提高對NMAS伴PPH的治療效果。
목적：탐토서지나비연합폐표면활성물질（ PS）대신생인태분흡입종합정（ NMAS）합병폐동맥고압（ PPH）환인치료효과，병총결호리경험。방법장60례NMAS합병PPH환인안수궤수자표법분위대조조화관찰조각30례。량조균채용고빈진탕보조통기、합괄보액、항생소등진행상규치료，대조조환인접수기관내적입PS，관찰조재대조조적기출상가용서지나비；비교량조환자치료전후적양합지수여폐포동맥양분압차치급치료후폐동맥압（ PAP）。결과치료후4，12 h량조환자양합지수（ OI）급폐포동맥양분압차（ A-aDO2）비교차이균유통계학의의（ P＜0．01）；치료36 h후，관찰조환인 OI 위（11．7±2．8），대조조위（19．1±3．4），량조비교차이유통계학의의（t＝9．202，P＜0．01）；관찰조A-aDO2위（12．1±3．2）mmHg，대조조위（27．6±5．5）mmHg，량조비교차이유통계학의의（t＝13．342，P＜0．01）。치료24～36 h후，관찰조여대조조PAP분별위（40．4±10．7） mmHg화（49．3±13．4） mmHg，량조비교차이구유통계학의의（t＝2．843，P＜0．01）。량조균무불량병발증발생。결론서지나비연합PS，동시주호호흡도호리급고빈진탕보조통기시기도호리，능진일보제고대NMAS반PPH적치료효과。
Objective To explore the treatment effect of sildenafil combined with pulmonary surfactant (PS) on newborn meconium aspiration syndrome ( NMAS) children with persistence pulmonary hypertension ( PPH) , and to summarize the nursing experience .Methods Sixty NMAS children with PPH were chosen and randomly divided into the control group and the observation group according to the random number table , each with 30 cases. All children received the routine treatment including high frequency oscillation assisted ventilation , proper rehydration , antibiotics and so on , and the control group received the intratracheal instillation of PS, and the observation group received the sildenafil on the basis of PS .The oxygenation index ( OI ) , alveolar-arterial oxygen difference ( A-aDO2 ) and pulmonary artery pressure ( PAP) were compared between two groups before and after the treatment .Results The differences were found in the OI and A-aDO2 4 and 12 h after the treatment between two groups (P<0.01); The OI was (11.7 ±2.8) in the observation group 36 h after the treatment, and was (19.1 ±3.4) in the control group, and the difference was statistically significant (t=9.202, P<0.01); the A-aDO2 was (12.1 ±3.2)mmHg in the observation group, and was (27.6 ± 5.5)mmHg in the control group, and the difference was statistically significant (t=13.342, P<0.01).The PAP was (40.4 ±10.7) mmHg in the observation group 24 ~36 h after the treatment, and was (49.3 ± 13.4)mmHg in the control group, and the difference was statistically significant (t=2.843, P<0.01).No serious complications were found in two groups .Conclusions The sildenafil combined with PS , meanwhile, the respiratory tract nursing and the high frequency oscillation assisted ventilation airway nursing were well , can further enhance the treatment effect of NMAS combined with PPH .
