CAJ | 학술논문

目的：探讨高频通气联合西地那非治疗新生儿持续性肺动脉高压临床疗效。方法选取2012年1月至2014年12月期间杭州美中宜和妇儿医院收治的60例持续性肺动脉高压新生儿，采用随机数字表法将其分成对照组和观察组，每组患者30例，其中对照组患儿仅给予高频通气治疗，观察组患儿在高频通气治疗的基础上给予西地那非治疗。比较两组患儿的临床治疗效果、治疗前后血气指标及肺动脉压和体循环收缩压改善情况，住院时间和费用，以及呼吸机使用时间。结果观察组患儿治愈率（66．7％）明显高于对照组（40．0％），χ2＝8．473，P＜0．05，观察组患儿死亡率（3．3％）明显低于对照组（20．0％），χ2＝6．549， P＜0．05；观察组患儿治疗后PaO2（67．4±6．7mmHg）及 SaO2（97．3±13．8％）明显高于对照组（60．3±9．3mmHg，90．7±13．5％），t值分别为4．78和5．43，均P＜0．05，观察组患儿治疗后PaCO2（32．3±4．1mmHg）明显低于对照组（43．7±4．6mmHg）， t＝5．12，P＜0．05；观察组患儿治疗后肺动脉压（27．5±2．3mmHg）明显低于对照组（57．2±3．2mmHg），t＝14．99，P＜0．05；观察组患儿住院时间、呼吸机使用时间以及住院费（14．2±2．4d，4．3±1．3d，7030±1310元），均明显低于对照组（17．8±3．2d，8．8±2．3d，7840±1430元），t值分别为7．83，14．92和8．76，均P＜0．05。结论高频通气联合西地那非能够明显改善新生儿持续性肺动脉高压临床症状，疗效显著，值得临床推广应用。
목적：탐토고빈통기연합서지나비치료신생인지속성폐동맥고압림상료효。방법선취2012년1월지2014년12월기간항주미중의화부인의원수치적60례지속성폐동맥고압신생인，채용수궤수자표법장기분성대조조화관찰조，매조환자30례，기중대조조환인부급여고빈통기치료，관찰조환인재고빈통기치료적기출상급여서지나비치료。비교량조환인적림상치료효과、치료전후혈기지표급폐동맥압화체순배수축압개선정황，주원시간화비용，이급호흡궤사용시간。결과관찰조환인치유솔（66．7％）명현고우대조조（40．0％），χ2＝8．473，P＜0．05，관찰조환인사망솔（3．3％）명현저우대조조（20．0％），χ2＝6．549， P＜0．05；관찰조환인치료후PaO2（67．4±6．7mmHg）급 SaO2（97．3±13．8％）명현고우대조조（60．3±9．3mmHg，90．7±13．5％），t치분별위4．78화5．43，균P＜0．05，관찰조환인치료후PaCO2（32．3±4．1mmHg）명현저우대조조（43．7±4．6mmHg）， t＝5．12，P＜0．05；관찰조환인치료후폐동맥압（27．5±2．3mmHg）명현저우대조조（57．2±3．2mmHg），t＝14．99，P＜0．05；관찰조환인주원시간、호흡궤사용시간이급주원비（14．2±2．4d，4．3±1．3d，7030±1310원），균명현저우대조조（17．8±3．2d，8．8±2．3d，7840±1430원），t치분별위7．83，14．92화8．76，균P＜0．05。결론고빈통기연합서지나비능구명현개선신생인지속성폐동맥고압림상증상，료효현저，치득림상추엄응용。
Objective To evaluate the clinical efficacy of high frequency ventilation combined with Sildenafil on treatment of persistent pulmonary hypertension of newborns. Methods During January 2012 to December 2014, 60 newborns with persistent pulmonary hypertension hospitalized in Hangzhou Amcare Women and Children ’ s Hospital were divided into control group and observation group according to random member table, and there were 30 patients in each group.The control group was treated with high frequency ventilation therapy only, and the observation group was treated with Sildenafil additionally.Two groups were compared in terms of clinical efficacy, arterial blood gas and pulmonary arterial pressure before and after treatment, improvement of circulation, hospitalization duration and cost, and using of ventilator.Results Compared with the control group, the cure rate was significantly higher in the observation group (66.7%vs 40.0%) (χ2 =8.473, P<0.05) and the mortality was significantly lower (3.3% vs 20.0%) (χ2 =6.549,P<0.05).After treatment PaO2 and SaO2 were significantly higher in the observation group (67.4 ±6.7mmHg vs 60.3 ±9.3mmHg, 97.3 ±13.8% vs 90.7 ±13.5%) (t value was 4.78 and 5.43, respectively, both P<0.05).Meanwhile, PaCO2 was obviously lower in the observation group (32.3 ±4.1mmHg vs 43.7 ±4.6mmHg) (t=5.12,P<0.05), so was pulmonary arterial pressure (27.5 ±2.3mmHg vs 57.2 ± 3.2mmHg) (t=14.99,P<0.05).The hospitalization duration, period of ventilator using and hospitalization cost of the observation group (14.2 ±2.4d, 4.3 ±1.3d, 7 030 ±1 310Yuan) were significantly shorter or lower than those of the control group (17.8 ±3.2d,8.8 ±2.3 d, 7840 ±1 430Yuan) (t value was 7.83, 14.92 and 8.76, respectively, all P<0.05).ConclusionThe high frequency ventilation combined with Sildenafil can improve the clinical symptoms of newborns with persistent pulmonary hypertension significantly, and it is very effective and worthy of clinical application.