前列地尔联合硫酸镁治疗新生儿持续肺动脉高压的临床疗效观察

摘要

Objective To observe the clinical effect of alprostadil combined with magnesium sulfate on persistent pulmonary hypertension of newborn. Methods A total of 68 children with persistent pulmonary hypertension were selected in the Maternal and Child Health Care Center of Hengyang from January 2011 to June 2013,and they were divided into control group and experiment group according to admission date( single or double),each of 34 cases. Control group given magnesium sulfate, while experiment group given alprostadil combined with magnesium sulfate. Clinical effect were compared, pulmonary arterial systolic pressure( PAXP),PaO2 and PaCO2 and mechanical ventilation time before and 3 days after treatment were detected, incidence of adverse reactions during treatment was observed. Results In experiment group,18 cases got excellent effect,10 cases got better effect,6 cases got invalid effect;in control group,7 cases got excellent effect,13 cases got better effect,14 cases got invalid effect,the clinical effect of experiment group was better than that of control group(P﹤0. 05). No significant differences of PAXP,PaO2,PaCO2 was found between the two groups before treatment(P﹥0. 05);while PAXP and PaCO2 of experiment group were lower than those of control group, PaO2 was higher ( P ﹤ 0. 05 ). Mechanical ventilation time of experiment group was shorter than that of control group ( P﹤0. 05 ). No one of both groups occurred obvious adverse reactions during treatment. Conclusion Alprostadil combined with magnesium sulfate has certain clinical effect and safety on persistent pulmonary hypertension of newborn,can effectively decrease PAXP and improve respiratory function.%目的：观察前列地尔联合硫酸镁治疗新生儿持续肺动脉高压的临床疗效。方法选择2011年1月—2013年6月入住衡阳市妇幼保健院新生儿ICU的持续肺动脉高压患儿68例，按住院单双日分为对照组和试验组，各34例。对照组患儿给予硫酸镁治疗，试验组患儿给予前列地尔联合硫酸镁治疗。两组患儿分别于治疗前和治疗3 d后检测肺动脉收缩压（ PAXP）、氧分压（ PaO2）、二氧化碳分压（ PaCO2）及上呼吸机时间，比较两种患儿临床疗效，观察治疗期间不良反应发生情况。结果试验组患儿显效18例、有效10例、无效6例，对照组患儿显效7例、有效13例、无效14例，试验组患儿临床疗效优于对照组（ P﹤0.05）。治疗前两组患儿PAXP、PaO2及PaCO2比较，差异无统计学意义（P﹥0.05）；治疗后试验组患儿PAXP、PaCO2低于对照组，PaO2高于对照组（P﹤0.05）。试验组患儿上呼吸机时间短于对照组（ P﹤0.05）。治疗期间两组患儿均未出现明显不良反应。结论前列地尔联合硫酸镁治疗新生儿持续肺动脉高压安全有效，能明显降低患儿PAXP、改善呼吸功能。