高频振荡通气联合多巴酚丁胺治疗新生儿持续性肺动脉高压的作用及其机制

发布时间：2019-01-04 12:01

【摘要】：目的探讨高频振荡通气联合多巴酚丁胺治疗新生儿持续性肺动脉高压(PPHN)的临床疗效及其机制。方法按照治疗方式不同,将94例PPHN患儿分为A组32例、B组32例和C组30例。三组性别、胎龄、日龄、体质量、肺动脉压、生产方式、原发病比较差异均无统计学意义(P均0.05)。A组采用常频机械通气联合多巴酚丁胺,B组采用单纯高频振荡通气,C组采用高频振荡通气联合多巴酚丁胺,观察三组临床疗效。同时,治疗前、治疗12、24、48 h检测三组血氧饱和度(Sp O2)、氧合指数(OI),治疗前、治疗48 h检测三组血清C反应蛋白(CRP)、脑钠肽(BNP)、D-二聚体(D-D)水平变化。结果 C组治疗总有效率(93.3%)高于A组(75.0%)、B组(68.7%)(P均0.05);治疗12、24、48 h,C组Sp O2高于同期A组、B组,OI低于同期A组、B组,差异有统计学意义(P均0.05);治疗48 h,C组血清CRP、BNP、D-D水平低于A组、B组(P均0.05)。结论高频振荡通气联合多巴酚丁胺能显著改善PPHN患儿的缺氧状态,提高临床疗效,其机制与降低血清CRP、BNP、D-D水平有关。
[Abstract]:Objective to investigate the clinical effect and mechanism of high frequency oscillatory ventilation combined with dobutamine in the treatment of neonatal persistent pulmonary hypertension (PPHN). Methods 94 children with PPHN were divided into three groups: group A (n = 32), group B (n = 32) and group C (n = 30). There was no significant difference in sex, gestational age, day age, body mass, pulmonary artery pressure, mode of production and primary disease among the three groups (all P 0. 05). A group were treated with normal frequency mechanical ventilation combined with dobutamine). Group B was treated with simple high frequency oscillatory ventilation, group C with high frequency oscillation ventilation combined with dobutamine. At the same time, blood oxygen saturation (Sp O 2) was detected in three groups before treatment for 48 h, and serum C-reactive protein (CRP), (CRP), brain natriuretic peptide (BNP), (BNP),) was detected 48 h before treatment and before treatment with oxygenation index (OI),). Changes of D-dimer (D-D) level. Results the total effective rate of group C (93.3%) was higher than that of group A (75.0%), B, 68.7%) (P). The Sp O 2 of group C was higher than that of group A at 48 h after treatment, and the OI of group B was lower than that of group A and group B (P 0.05). The serum CRP,BNP,D-D level in group C was lower than that in group A and group B 48 h after treatment. Conclusion High frequency oscillatory ventilation combined with dobutamine can significantly improve the anoxic state and clinical efficacy in children with PPHN. The mechanism is related to the decrease of serum CRP,BNP,D-D level.
【作者单位】：武汉市儿童医院;
【基金】：湖北省自然科学基金资助项目(2011CHB042)
【分类号】：R722.19

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