目的 观察前列地尔在新生儿持续肺动脉高压治疗中的临床疗效.方法 在机械通气治疗新生儿呼吸衰竭基础上通过调节呼吸机参数及药物治疗后,血氧饱和度仍低于83％的患儿通过心脏超声证实为新生儿持续肺动脉高压者41例,将其分成两组,对照组气管内滴注肺表面活性物质(200 mg/kg),治疗组气管内滴注肺表面活性物质(200 mg/kg)再加用前列地尔(5 ng·kg-1·min-1)持续静滴6h,连用3d,在治疗期间监测肺动脉压、血压及血气分析.结果 治疗24 h后患儿的SaO2开始上升,治疗48 h后肺动脉压下降PaO2上升,治疗72 h后PaCO2明显下降,与治疗前比较差异均有统计学意义(P＜0.05).治疗中无一例出现低血压不良反应.对照组治愈率为65％,死亡率为10％,治疗组治愈率为85.7％,死亡率为4.8％.结论 前列地尔联合肺表面活性物质治疗新生儿持续肺动脉高压疗效较好,值得推广.%Objective To observe the effect of alprostadi and pulmonary surfactant in the treatment of neonates with persistent pulmonary hypertension.Methods After regulation of ventilator parameters and drug treatment on the basis of mechanical ventilation in the treatment of neonatal respiratory failure,41 children with oxygen saturation below 83％ confirmed by echocardiography as persistent pulmonary hypertension were enrolled in the study.The children were divided into two groups.The control group (n=20)applied intratracheal instillation of pulmonary suffacrant (200 mg/kg),while the treatment group (n=21)used intratracheal instillation of pulmonary surfactant (200 mg/kg)coupled with 6 h continuous intravenous infusion of alprostadil (5 ng· kg-1· min-1)for 3 days.During the treatment,the pulmonary arterial pressure,blood pressure and blood gas analysis were monitored.Results In the patients,SaO2began to rise after 24 h of treatment,pulmonary artery pressure decreased and PaO2 increased after 48 h of treatment,PaCO2 decreased significantly after 72 h of treatment (P＜0.05).During the treatment,no case was found with adverse reaction of hypotension.In the control group,the cure rate was 65％ and mortality rate was 10％,while the cure rate was 85.7％ and mortality rate was 4.8％ in the treatment group.Conclusion Alprostadil and pulmonary surfactant has good curative effect for neonates with persistent pulmonary hypertension,which is worthy of popularization
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