林玉，林小燕（广东省茂名市妇幼保健院新生儿科，广东　茂名525000）

一氧化氮吸入治疗新生儿持续肺动脉高压的效果观察及护理

林玉，林小燕
（广东省茂名市妇幼保健院新生儿科，广东茂名525000）

目的：探讨一氧化氮吸入治疗新生儿持续肺动脉高压的临床疗效及护理措施。方法：选取84例持续肺动脉高压患儿给予高频振荡模式机械通气，在较高通气参数下，予一氧化氮吸入治疗，记录吸入一氧化氮前、吸入后30 min、吸入后24 h的经皮血氧饱和度（SpO2）、血气分析、血压、心率、平均动脉压及氧合指数（OI）。结果：治疗后30 min及治疗后24 h SpO2、PaO2、PaCO2、FiO2、OI差异有统计学意义（P＜0.05），不同治疗时间点患儿HR、SPAP、SBP、MAP、pH值差异无统计学意义（P＞0.05）。结论：一氧化氮吸入联合高频振荡模式机械通气治疗新生儿持续肺动脉高压疗效确切，显著改善患儿OI，血气分析、血氧饱和度等指标，通过有效的护理措施可避免一氧化氮相关不良反应的发生。

一氧化氮；新生儿；持续肺动脉高压；临床疗效；护理措施

doi：10.16753/j.cnki.1008-2344.2016.04.017

［Abstract］Objective：To analysis clinical efficacy of inhaled nitric oxide in the treatment of persistent pulmonary hypertension of the newborn and nursing.Methods：A total of 84 cases of persistent pulmonary hypertension of the newborn received high-frequency oscillation mode of mechanical ventilation at higher ventilation parameters，and inhaled nitric oxide therapy.Before inhalation of nitric oxide and 30 min，24 h after inhalation of nitric oxide，transcutaneous oxygen saturation（SpO2），blood gas analysis，blood pressure，heart rate，mean arterial blood pressure and oxygenation index（OI）were recorded.Results：There was significant difference in SpO2，PaO2，PaCO2，FiO2，OI at 30 min and 24 h after inhalation of nitric oxide（P＜0.05）.There was no significant difference in HR，SPAP，SBP，MAP，pH（P＞0.05）.Conclusion：Inhaled nitric oxide combined with a high-frequency oscillation mode of mechanical ventilation in newborns with persistent pulmonary hypertension significantly improve OI，blood gas analysis，oxygen saturation and other indicators，and effective interventions can avoid nitric oxide-related adverse reactions.

［Key words］nitric oxide；newborn；persistent pulmonary hypertension；clinical efficacy；nursing

新生儿持续肺动脉高压是新生儿重症监护室中常见的新生儿急危重症，治疗难度大，病死率高，诱发该病的基础疾病较多，临床上普遍认为主要有：（1）胎儿胎粪吸入、肺发育不良、呼吸窘怕综合征等肺实质性疾病；（2）胎儿在母体宫腔内长期缺氧、围产期出现窒息；（3）患儿有肺炎或者败血症等病毒性感染及心脏收缩功能异常，肺微血管出现栓塞，血黏度增高，最终导致患儿的肺血管痉挛［1］；（4）母体服用抗炎药物促使宫腔内的动脉导管关闭造成肺动脉高压。……