右江民族医学院学报
右江民族醫學院學報
우강민족의학원학보
JOURNAL OF YOUJIANG MEDICAL COLLEGE FOR NATIONALITIES
2015年
1期
88-89,91
,共3页
婴儿,新生%高血压,肺性%一氧化氮%吸入法
嬰兒,新生%高血壓,肺性%一氧化氮%吸入法
영인,신생%고혈압,폐성%일양화담%흡입법
infant,newborn%hypertension,pulmonary%nitric oxide%inhalation
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4~24 h 在呼吸机支持同时加 NO 吸入治疗。NO 吸入前、后0.5 h、6 h、12 h、24 h、48 h 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48 h 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)。24~48 h 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<2 ppm。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。
目的:探討吸入一氧化氮(NO)對新生兒持續肺動脈高壓(PPHN)的治療效果。方法對20例臨床診斷PPHN 的患兒進行 NO 吸入治療,入院後經高頻振盪機械通氣呼吸支持,應用 NO 前呼吸機吸入氧濃度(FiO2)為(0.91±0.12),氣道壓力(MAP)為(1.31±0.21)kPa,入院4~24 h 在呼吸機支持同時加 NO 吸入治療。NO 吸入前、後0.5 h、6 h、12 h、24 h、48 h 動態觀察經皮血氧飽和度(SpO2)、血氣動脈血氧分壓(PaO2)、MAP、氧閤指數(OI)、心率(HR)、血壓(BP)的測定。結果患兒吸入 NO 治療48 h 內經皮 SpO2明顯上升,OI、MAP 明顯下降(P <0.05),PaO2明顯上升(P <0.05),而 HR、BP 無明顯變化(P >0.05)。24~48 h 後經皮 SpO2持續穩定。治愈18例,2例死于嚴重併髮癥,吸入 NO 時二氧化氮(NO2)濃度鑑測均<2 ppm。結論NO 吸入能選擇性擴張肺血管,改善氧閤,對心血管無明顯不良反應,在保證有效通氣及良好灌註時為有效的治療 PPHN 的手段。
목적:탐토흡입일양화담(NO)대신생인지속폐동맥고압(PPHN)적치료효과。방법대20례림상진단PPHN 적환인진행 NO 흡입치료,입원후경고빈진탕궤계통기호흡지지,응용 NO 전호흡궤흡입양농도(FiO2)위(0.91±0.12),기도압력(MAP)위(1.31±0.21)kPa,입원4~24 h 재호흡궤지지동시가 NO 흡입치료。NO 흡입전、후0.5 h、6 h、12 h、24 h、48 h 동태관찰경피혈양포화도(SpO2)、혈기동맥혈양분압(PaO2)、MAP、양합지수(OI)、심솔(HR)、혈압(BP)적측정。결과환인흡입 NO 치료48 h 내경피 SpO2명현상승,OI、MAP 명현하강(P <0.05),PaO2명현상승(P <0.05),이 HR、BP 무명현변화(P >0.05)。24~48 h 후경피 SpO2지속은정。치유18례,2례사우엄중병발증,흡입 NO 시이양화담(NO2)농도감측균<2 ppm。결론NO 흡입능선택성확장폐혈관,개선양합,대심혈관무명현불량반응,재보증유효통기급량호관주시위유효적치료 PPHN 적수단。
Objective To study the therapeutic efficacy of inhaling nitric oxide (NO)for treating newbo-rns with persistent pulmonary hypertension (PPHN). Methods Twenty neonates diagnosed of PPHN re-ceived NO inhaling.High frequency oscillatory mechanical ventilation was used after neonates were admitted to hospital.Before use of NO inhaling,ventilator oxygen concentration (FiO 2 )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 frequen-cy oscillatory ventilation therapy was performed 4~24 hours after neonates were admitted to hospital.Percuta-neous oxygen saturation (SpO2 ),arterial partial pressure of oxygen (PaO 2 )of blood gas,MAP,oxygenation index(OI),blood pressure (BP)and heart rate (HR)were measured at baseline,0.5h,6h,12h,24h and 48h after NO therapy. Results Following 48-hour inhalation of NO,percutaneous SpO 2 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 SpO 2 were noticed within 24~48 hours of NO thera-py.Eighteen neonates cured and 2 died from severe complications,which the monitoring NO 2 concentration was all<2 ppm while NO inhalation. Conclusion This preliminary clinical experience suggests that NO inha-lation may be an effective therapy for PPHN,which can selectivelly enlarge pulmonary vessels,improve oxy-genation,without adverse reaction,guarantee adequate ventilation and good perfusion.