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目的探讨肺表面活性物质(PS)联合西地那非与持续性正压通气(CPAP)治疗新生儿持续肺动脉高压(PPHN)的临床效果。方法选取2014年6月-2016年6月瑞安市妇幼保健院收治的70例PPHN患儿为研究对象,将入选患儿随机分为对照组和观察组,每组各35例,两组患儿均接受西地那非联合CPAP治疗,观察组患儿在此基础上应用PS治疗,对比分析两组患儿临床治疗效果。结果两组患儿治疗前的吸入氧浓度(FiO_2)、动脉血氧分压(PaO_2)和肺动脉压值比较,差异无统计学意义(P>0.05),接受治疗24 h、48 h后两组患儿的FiO_2、PaO_2和肺动脉压测定值均较治疗前显著改善(P<0.05),并且观察组患儿的改善效果优于对照组患儿(P<0.05)。观察组患儿的治疗总有效率为97.1%,对照组为82.9%,两组比较,差异有统计学意义(P<0.05)。观察组患儿的CAPA治疗时间、吸氧时间和住院时间均显著少于对照组(P<0.05)。结论 PS联合西地那非与CPAP治疗PPHN患儿有明显疗效,在改善患儿血气水平和肺动脉压方面有优势。
Objective To investigate the clinical effect of pulmonary surfactant (PS) combined with sildenafil and continuous positive airway pressure (CPAP) on neonatal persistent pulmonary hypertension (PPHN). Methods From June 2014 to June 2016, 70 children with PPHN who were admitted to the MCH hospital in Rui’an City were selected as the research objects. The children were randomly divided into control group and observation group, 35 cases in each group, two groups of children All received sildenafil combined CPAP treatment, observation group of children on the basis of PS treatment, comparative analysis of two groups of children with clinical treatment. Results There was no significant difference in FiO 2, PaO 2 and pulmonary arterial pressure between the two groups before treatment (P> 0.05). After treatment for 24 h and 48 h, there were no significant differences between the two groups The measured values of FiO 2, PaO 2 and pulmonary arterial pressure in children were significantly improved compared with that before treatment (P <0.05), and the improvement effect in observation group was better than that in control group (P <0.05). The total effective rate of treatment group was 97.1% in the observation group and 82.9% in the control group. There was significant difference between the two groups (P <0.05). CAPA treatment time, oxygen inhalation time and hospital stay in observation group were significantly less than those in control group (P <0.05). Conclusion PS combined with sildenafil CPAP treatment of children with PPHN have a significant effect, in improving blood gas levels and pulmonary artery pressure in children with advantages.