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利用彩色多普勒超声心动图技术 ,评价一氧化氮 (NO)吸入治疗新生儿肺动脉高压的疗效。对 8例新生儿因肺炎、肺透明膜病、持续胎儿循环和先天性支气管肺发育不良并发呼吸衰竭而采用机械通气和NO吸入治疗。NO吸入浓度为 3～2 0ppm ,吸入时间为 1小时～ 35天。多普勒超声心动图利用三尖瓣返流或动脉导管未闭定量估测NO吸入前后肺动脉收缩压 (SPAP) ,同时测量上肢收缩压 (SBP) ,计算肺 /体压力 (Pp/Ps)比值。结果显示 :NO吸入 30～ 1 2 0分钟和 1 8～ 2 4小时后 ,SPAP分别由NO吸入前的 5 7± 1 1 .6mmHg降至 41± 1 0 8mmHg和 43± 1 8 2mmHg ;Pp/Ps分别由 0 87± 0 1 5降至 0 6 1± 0 1 5和 0 6 3± 0 2 1。NO吸入前后SBP无明显变化。NO吸入后卵圆孔、动脉导管和室间隔缺损水平右向左或双向分流较吸入前明显减少。结论 NO吸入治疗新生儿肺动脉高压安全有效。彩色多普勒超声心动图技术对于指导NO的临床应用具有重要价值
Color Doppler echocardiography was used to evaluate the efficacy of nitric oxide inhalation in the treatment of neonatal pulmonary hypertension. Eight neonates were treated with mechanical ventilation and NO inhalation for pneumonia, hyaline membrane disease, persistent fetal circulation and congenital bronchopulmonary dysplasia with respiratory failure. NO inhalation concentration of 3 ~ 20ppm, inhalation time of 1 hour to 35 days. Doppler echocardiography Pulmonary artery systolic pressure (SPAP) was measured before and after inhalation of NO using tricuspid regurgitation or patent ductus arteriosus quantitatively, and systolic pressure (SBP) of the upper extremities was measured to calculate the ratio of pulmonary / body pressure (Pp / Ps) . The results showed that SPAP decreased from 57 ± 116mmHg before NO inhalation to 41 ± 1108mmHg and 43 ± 182mmHg respectively after NO inhalation for 30 to 120 minutes and from 18 to 24 hours. Pp / Ps decreased from 0 87 ± 0 1 5 to 0 6 1 ± 0 1 5 and 0 6 3 ± 0 2 1, respectively. There was no significant change in SBP before and after NO inhalation. NO inhalation of foramen, ductus arteriosus and ventricular septal defect right-left or bidirectional shunt than before inhalation significantly reduced. Conclusion NO inhalation is safe and effective in the treatment of neonatal pulmonary hypertension. Color Doppler echocardiography is of great value in guiding the clinical application of NO