Clinical Analysis Of Sildenafil And Inhaled Nitric Oxide In The Treatment Of PPHN

Objective:Analysis of our department of neonatal continuous pulmonary hypertension clinical experience,aimed at looking for more ideal and effective treatment of children with PPHN method.Methods:During September 2014 to February 2017 in our neonatal hospital,140 newborns with presistent pulmonary hypertension hospitalized in Neonatal department of No.1 Hospital of Jilin University.Retrospective analysis was made on 140 cases that met the inclusion criteria and clinical data.According to this different treatment program is divided into A,B,C three groups,Group A: classic treatment group,a total of 30 cases of children,gestational age 37.64 ± 3.44 weeks,birth weight 2.90± 0.68kg;B group: classic treatment combined with sildenafil,a total of84 cases,gestational age 37.24 ± 3.13 weeks,birth weight 2.95 ± 0.75kg;Group C: classic treatment combined with i NO,a total of 26 cases ofchildren,gestational age of 38.12 ± 2.51 weeks,birth weight 2.95 ±0.66 kg.The differences of PAP,Sa O2,Fi O2 and blood gas analysis were analyzed before and after treatment in the three groups of children,gestational age,birth weight,mode of delivery,sex,hospitalization time,use of ventilator treatment time,treatment efficiency,major disease and before and after treatment.Results:1.PPHN is more common in term infants.2.ARDS in the disease occupied the first place,followed by the wet lung.3.There were significant differences in blood gas analysis between the three groups before and after treatment(P <0.05).After treatment,B and C were better than group A(P <0.05).4.There were significant differences in Fi O2,Sa O2 and PAP between the three groups(P <0.05).After treatment,B and C were better than group A(P <0.05).5.The effective rate of treatment in group B and C was higher than that in group A.6.The effective rate of treatment in group B and C was higher than that in group A.7.The treatment efficiency of group B and C was higher than that of group A.8.The time of operation and hospitalization in group A was higher than that in group B and C.There was no statistical difference between the two groups.9.The clinical efficacy,treatment efficiency,hospitalization and ventilator treatment time of B and C groups were not statistically significant.Conclusions:1.PPHN was mainly seen in the term infants,its neonatal respiratory distress syndrome and wet lung were the main pathogenic factors.2.Classical method combined with sildenafil or combined i NO treatment of PPHN can effectively improve the p H,Pa CO2 and Pa O2.3.Classical method combined with sildenafil or combined with i NO treatment of PPHN can effectively reduce neonatal PAP,shorten the course of hospitalization and the use of ventilator treatment time.4.Classical method combined with sildenafil or combined with i NO treatment of PPHN is more effective than classical therapy.5.There was no significant difference in clinical efficacy and therapeutic efficiency between sildenafil and i NO in the treatment of PPHN.6.Sildenafil and i NO can be used with in 34 weeks of premature infants PPHN treatment.However,the number of cases is less and needs further study.