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目的:探讨高频震荡通气(HFOV)联合米力农治疗新生儿持续肺动脉高压(PPHN)的疗效。方法:将30例肺源性PPHN患儿随机分成三组各10例:(1)CMV+米力农组,应用常频机械通气(CMV)联合米力农治疗;(2)HFOV组,应用HFOV治疗;(3)HFOV+米力农组,应用HFOV联合米力农治疗。米力农用法用量:负荷量50μg/kg,60 min静脉滴注,然后以0.50～0.75μg/(kg.min)维持,连用3 d。监测治疗前后氧合指数(OI)、PaO2/FiO2和血压,比较三组患儿疗效。结果:三组OI、PaO2/FiO2治疗前比较差异无统计学意义(P>0.05),均随着治疗时间的延长而逐渐改善,以HFOV+米力农组改善最为显著,治疗2 h时开始出现明显改善(OI:28.76±5.12→21.06±2.79;PaO2/FiO2:44.74±11.60→57.65±17.53),而另两组改善不明显,在治疗2h、12 h、24 h、36 h时HFOV+米力农组分别与另两组进行两两比较差异均有统计学意义(P<0.05)。三组治疗期间均未出现低血压,治疗后CMV+米力农组、HFOV组、HFOV+米力农组总有效率分别为80.0%、60.0%、90.0%,组间比较差异均有统计学意义(P<0.05)。结论:HFOV联合米力农治疗新生儿肺源性PPHN可有效改善氧合,对血压无明显影响。
Objective: To investigate the efficacy of high frequency oscillatory ventilation (HFOV) combined with milrinone in the treatment of neonatal persistent pulmonary hypertension (PPHN). Methods: Thirty patients with pulmonary PPHN were randomly divided into three groups of 10 cases: (1) CMV + Milrinone group, treated with CMV combined with Milrinone; (2) HFOV group, treated with HFOV Treatment; (3) HFOV + Milirong group, the application of HFOV combined with Milinone treatment. Millet agricultural usage: load 50μg / kg, 60 min intravenous infusion, and then 0.50 ~ 0.75μg / (kg.min) to maintain, once every 3 d. Oxygenation index (OI), PaO2 / FiO2 and blood pressure were monitored before and after treatment. The curative effect was compared between the three groups. Results: There was no significant difference in OI and PaO2 / FiO2 between the three groups before and after treatment (P> 0.05), both of them improved gradually with the prolongation of treatment time. The improvement was most obvious in HFOV + Milrinone group, (OI: 28.76 ± 5.12 → 21.06 ± 2.79; PaO2 / FiO2: 44.74 ± 11.60 → 57.65 ± 17.53), while the other two groups showed no significant improvement. HFOV + miller force at 2h, 12h, 24h, The differences between the two groups were statistically significant (P <0.05). No hypotension occurred during the three treatment periods. The total effective rates were 80.0%, 60.0% and 90.0% in CMV + Milrinone group, HFOV group and HFOV + Milrinone group after treatment respectively. There were significant differences between the two groups P <0.05). Conclusion: HFOV combined with milrinone in the treatment of neonatal pulmonary PPHN can effectively improve oxygenation and have no significant effect on blood pressure.