硫酸镁联合常频机械通气治疗新生儿持续肺动脉高压的临床研究

摘要

目的：观察硫酸镁联合常频机械通气治疗新生儿持续肺动脉高压(PPHN)的临床效果。方法：选择60例确诊并接受治疗的PPHN患儿，根据就诊时间的不同将其分为观察组与对照组，每组30例。两组均给予常频机械通气，观察组同时给予硫酸镁药物治疗。观察两组治疗前及治疗后6 h、24 h及48 h动脉血气情况，每日监测患者血镁、血钙；治疗前及治疗48 h后采用床旁超声心动图监测肺动脉收缩压(PAP)；观察有无不良反应。结果：两组患儿治疗6 h、24 h后，观察组患儿pH值、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、经皮血氧饱和度(TcSaO2)等指标明显优于对照组，治疗48 h后观察组PaCO2、PaO2、pH值和TcSaO2指标显著高于对照组，差异有统计学意义(t=11.091, t=6.243，t=18.079，t=15.229；P＜0.05)。血镁值浓度水平达到了有效的治疗浓度、血钙值浓度水平维持在正常范围内；观察组患儿PAP下降较对照组显著，差异有统计学意义(t=8.918，P＜0.05)；治疗中未见明显的不良反应。结论：硫酸镁联合常频机械通气治疗新生儿持续肺动脉高压效果好，技术操作简单，值得推广应用。%Objective: To observe the clinical results of magnesium sulfate and conventional mechanical ventilation in the treatment of persistent pulmonary hypertension of newborn. Methods:Two groups of newborn with PPHN, were treated with conventional mechanical ventilation;The observation group was treated with magnesium sulfate saturation, and then adjusted its amount according to their condition, and then gradually decrease until stopped. Before treatment and after treatment 6 h, 24 h, 48 h, to observe arterial blood gas situation, daily monitoring of blood magnesium and blood calcium. Before treatment and after treatment 48 h, to measure pulmonary artery systolic pressure(PAP)by bedside echocardiography; To observe the adverse reactions. Results: After treatment, the observation group more significantly increased in PH value, PaO2(mmHg), TcSaO2(%),and more significantly declined in PaCO2(mmHg) than those in the control group (t=11.091, t=6.243, t=18.079, t=15.229; P<0.05). Blood Mg(mmol/L) reached an effective therapeutic concentrations, blood Ca(mmol/L) values were maintained within the normal range;the observation group more significantly declined in PAP(t=8.918, P<0.05);there were no serious adverse reaction. Conclusion:There are very good curative effect in the treatment of persistent pulmonary hypertension of newborn, with magnesium sulfate and conventional mechanical ventilation, the technology is simple and worth promotion.