【摘要】 目的探讨高频振荡通气与西地那非联合治疗方案对新生儿持续性肺动脉高压（PPHN）的影响。方法选取2014年3月～2018年3月承德医学院附属医院收治的109例PPHN患儿为研究对象。按照随机数字表法将患儿分为对照组（54例）和研究组（55例）。对照组予高频振荡通气治疗,研究组予西地那非联合治疗。比较两组患儿治疗72 h后临床疗效,比较两组患儿治疗前后动脉血二氧化碳分压（PaCO₂）、吸入氧浓度（FiO₂）、动脉血氧饱和度（SaO₂）、动脉血氧分压（PaO₂）、肺动脉压力（SPAP）、体循环血压（SBP）。观察并比较两组患儿治疗期间不良反应发生情况。结果研究组患儿治疗后总有效率显著高于对照组,差异有统计学意义（P <0.05）。两组患儿治疗后PaCO₂、FiO₂均较本组治疗前降低,且研究组低于对照组（P <0.05）;两组患儿治疗后SaO₂、PaO₂均较本组治疗前升高,且研究组高于对照组（P <0.05）。研究组患儿治疗后SPAP显著低于治疗前（P <0.05）,对照组患儿治疗前后SPAP差异无统计学意义（P> 0.05）,治疗后研究组低于对照组（P <0.01）。两组患儿治疗前后SBP组内及组间比较,差异均无统计学意义（P> 0.05）。两组患儿治疗期间不良反应发生率比较,差异无统计学意义（P>0.05）。结论高频振荡通气与西地那非联合治疗新生儿PPHN,疗效较佳,可显著改善患儿临床症状以及相关临床指标,临床应用价值较高。更多还原

【Abstract】 Objective To investigate the effect of high frequency oscillatory ventilation combined with Sildenafil in the treatment of neonatal persistent pulmonary hypertension（PPHN）. Methods A total of 109 newborns with PPHN admitted to the Affiliated Hospital of Chengde Medical College from March 2014 to March 2018 were selected as subjects.Newborns were divided into control group（54 cases） and study group（55 cases） according to random number table method. The control group was treated with high frequency oscillatory ventilation, and the study group was treated with Sildenafil. The clinical effect of the two groups was compared after 72 hours′ treatment. The arterial partial pressure of carbon dioxide（PaCO₂）, fraction of inspired oxygen（FiO₂）, arterial oxygen saturation（SaO₂）, arterial partial pressure of oxygen（PaO₂）, pulmonary artery pressure（SPAP） and systemic blood pressure（SBP） were compared between the two groups before and after treatment. Adverse reactions of the two groups during treatment were observed. Results The total effective rate of the study group was significantly higher than that of the control group, and the difference was statistically significant（P < 0.05）. The PaCO₂ and FiO₂ of the two groups were lower than those before treatment,and those in the study group were lower than those in the control group（P < 0.05）. The SaO₂ and PaO₂ of the two groups increased after treatment, and those in the study group were higher than those in the control group（P < 0.05）. The SPAP of the study group after treatment was significantly lower than that before treatment（P < 0.05）,while there was no significant difference in the control group before and after treatment（P > 0.05）, and that in the study group was lower than the control group（P < 0.05）. There was no significant difference in SBP before and after treatment in the same group nor between the two groups（P > 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups during treatment（P > 0.05）. Conclusion High frequency oscillatory ventilation combined with Sildenafil in the treatment of PPHN is effective remarkbly, which can significantly improve clinical symptom and related clinical indicators, and it has high clinical application value.更多还原