一例新生儿胎粪吸入综合征合并肺动脉高压的循证治疗_《中国循证医学杂志》

作者：

 韩树萍 , 余章斌 , 陈玉林 , 邱玉芳 , 程佳 , 沙莉 , 吴丹青 , 李亚琴

南京医科大学附属南京妇幼保健院儿科（南京 210004）;

关键词：

胎粪吸入综合征新生儿持续肺动脉高压循证治疗

DOI：

10.7507/1672-2531.20090243

视频：

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摘要 全文 图表 视频 参考文献 施引文献 补充材料

目的　探讨新生儿胎粪吸入综合征合并肺动脉高压的循证治疗方法。
方法　针对患儿的临床问题，以肺动脉高压、新生儿、胎粪吸入综合征、治疗为主题词和自由词，计算机检索 Cochrane 图书馆（2009 年第2 期）、MEDLINE（1980 ～ 2009.6）、ACP Journal Club（1991 年1 月～ 2009 年9 月）和中国期刊全文数据库（1994 ～ 2009年6 月），查找相关的系统评价、随机对照试验和临床回顾性研究等，并评价所获证据的质量和适用性。
结果　共纳入2 个系统评价、1 个Meta 分析，9 个随机对照试验和1 个卫生经济学评价。所获证据显示：① 使用体外膜肺治疗可减少患儿的病死率，但会增加治疗成本；② 吸入一氧化氮可显著升高患儿的动脉血氧分压、减少使用体外膜肺；③ 目前尚无评价过度通气、高频通气、控制性碱血症、扩血管药物（硫酸镁、妥拉苏林、前列腺素与前列环素、米力农）及肺表面活性物质治疗新生儿持续肺动脉高压临床效果的随机对照试验；④ 口服西地那非可降低持续肺动脉高压患儿的氧合指数，降低住院期间患儿的病死率。结合医院现有条件、患儿情况及其家属的意愿，口服西地那非治疗后患儿给氧浓度降低，逐渐撤离呼吸机，一般情况可，1 个月后治愈出院。
结论　采用循证治疗方法，为胎粪吸入综合征合并肺动脉高压的新生儿制定合理的治疗方案，可有效提高治疗效果，提高患儿生存率。

引用本文： 韩树萍,余章斌,陈玉林,邱玉芳,程佳,沙莉,吴丹青,李亚琴. 一例新生儿胎粪吸入综合征合并肺动脉高压的循证治疗. 中国循证医学杂志, 2009, 09(12): 1339-1342. doi: 10.7507/1672-2531.20090243 复制

1.	Konduri GG, Kim UO. Advances in the diagnosis and management of persistent pulmonary hypertension of the newborn. Pediatr Clin North Am, 2009, 56(3): 579-600.
2.	Ho JJ, Rasa G. Magnesium sulfate for persistent pulmonary hypertension of the newborn. Cochrane Database Syst Rev, 2007(3): CD005588.
3.	Shah PS, Ohlsson A. Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev, 2007(3): CD005494.
4.	Oliveira CA, Troster EJ, Pereira CR. Inhaled nitric oxide in the management of persistent pulmonary hypertension of the newborn: a meta-analysis. Rev Hosp Clin Fac Med Sao Paulo, 2000, 55(4): 145-154.
5.	Clark RH, Kueser TJ, Walker MW, et al. Low-dose nitric oxide therapy for persistent pulmonary hypertension of the newborn. Clinical Inhaled Nitric Oxide Research Group. N Engl J Med, 2000, 342(7): 469-474.
6.	Roberts JD Jr, Fineman JR, Morin FC, et al. Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. The Inhaled Nitric Oxide Study Group. N Engl J Med, 1997, 336(9): 605-610.
7.	Wessel DL, Adatia I, Van Marter LJ, et al. Improved oxygenation in a randomized trial of inhaled nitric oxide for persistent pulmonary hypertension of the newborn. Pediatrics, 1997, 100(5): E7.
8.	Davidson D, Barefield ES, Kattwinkel J, et al. Inhaled nitric oxide for the early treatment of persistent pulmonary hypertension of the term newborn: a randomized, double-masked, placebo-controlled, dose-response, multicenter study. The I-NO/PPHN Study Group. Pediatrics, 1998, 101(3 Pt 1): 325-334.
9.	Christou H, Van Marter LJ, Wessel DL, et al. Inhaled nitric oxide reduces the need for extracorporeal membrane oxygenation in infants with persistent pulmonary hypertension of the newborn. Crit Care Med, 2000, 28(11): 3722-3727.
10.	Sadiq HF, Mantych G, Benawra RS, et al. Inhaled nitric oxide in the treatment of moderate persistent pulmonary hypertension of the newborn: a randomized controlled, multicenter trial. J Perinatol, 2003, 23(2): 98-103.
11.	Baquero H, Soliz A, Neira F, et al. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinded study. Pediatrics, 2006, 117(4): 1077-1083.
12.	Bifano EM, Hakanson DO, Hingre RV, et al. Prospective randomized controlled trial of conventional treatment or transport for ECMO in infants with persistent pulmonary hypertension (PPHN). Pediatr Res, 1992, 31(8): 196A.
13.	O’Rourke PP, Crone RK, Vacanti JP, et al. Extracorporeal membrane oxygenation and conventional medical therapy in neonates with persistent pulmonary hypertension of the newborn: a prospective randomized study. Pediatrics, 1989, 84(6): 957-963.
14.	Lorch SA, Cnaan A, Barnhart K. Cost-effectiveness of inhaled nitric oxide for the management of persistent pulmonary hypertension of the newborn. Pediatrics, 2004, 114(2): 417-426.
15.	杜立中, 魏克伦, 孙眉月. 新生儿持续肺动脉高压诊疗常规. 中华围产医学杂志, 2003, 6(1): 61-62.
16.	Mugford M, Elbourne D, Field D. Extracorporeal membrane oxygenation for severe respiratory failure in newborn infants. Cochrane Database Syst Rev, 2008(3): CD001340.
17.	Frostell C, Fratacci MD, Wain JC, et al. Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation, 1991, 83(6): 2038-2047.
18.	Tolsa JF, Cotting J, Sekarski N, et al. Magnesium sulphate as an alternative and safe treatment for severe persistent pulmonary hypertension of the newborn. Arch Dis Child Fetal Neonatal Ed, 1995, 72(3): F184-187.
19.	Abu-Osba YK, Galal O, Manasra K, et al. Treatment of severe persistent pulmonary hypertension of the newborn with magnesium sulphate. Arch Dis Child, 1992, 67(1 Spec No): 31-35.
20.	Young TE. Neofax. 19th ed. Raleigh: Acorn Publishing Inc, 2006: 136-146.

1. Konduri GG, Kim UO. Advances in the diagnosis and management of persistent pulmonary hypertension of the newborn. Pediatr Clin North Am, 2009, 56(3): 579-600.
2. Ho JJ, Rasa G. Magnesium sulfate for persistent pulmonary hypertension of the newborn. Cochrane Database Syst Rev, 2007(3): CD005588.
3. Shah PS, Ohlsson A. Sildenafil for pulmonary hypertension in neonates. Cochrane Database Syst Rev, 2007(3): CD005494.
4. Oliveira CA, Troster EJ, Pereira CR. Inhaled nitric oxide in the management of persistent pulmonary hypertension of the newborn: a meta-analysis. Rev Hosp Clin Fac Med Sao Paulo, 2000, 55(4): 145-154.
5. Clark RH, Kueser TJ, Walker MW, et al. Low-dose nitric oxide therapy for persistent pulmonary hypertension of the newborn. Clinical Inhaled Nitric Oxide Research Group. N Engl J Med, 2000, 342(7): 469-474.
6. Roberts JD Jr, Fineman JR, Morin FC, et al. Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. The Inhaled Nitric Oxide Study Group. N Engl J Med, 1997, 336(9): 605-610.
7. Wessel DL, Adatia I, Van Marter LJ, et al. Improved oxygenation in a randomized trial of inhaled nitric oxide for persistent pulmonary hypertension of the newborn. Pediatrics, 1997, 100(5): E7.
8. Davidson D, Barefield ES, Kattwinkel J, et al. Inhaled nitric oxide for the early treatment of persistent pulmonary hypertension of the term newborn: a randomized, double-masked, placebo-controlled, dose-response, multicenter study. The I-NO/PPHN Study Group. Pediatrics, 1998, 101(3 Pt 1): 325-334.
9. Christou H, Van Marter LJ, Wessel DL, et al. Inhaled nitric oxide reduces the need for extracorporeal membrane oxygenation in infants with persistent pulmonary hypertension of the newborn. Crit Care Med, 2000, 28(11): 3722-3727.
10. Sadiq HF, Mantych G, Benawra RS, et al. Inhaled nitric oxide in the treatment of moderate persistent pulmonary hypertension of the newborn: a randomized controlled, multicenter trial. J Perinatol, 2003, 23(2): 98-103.
11. Baquero H, Soliz A, Neira F, et al. Oral sildenafil in infants with persistent pulmonary hypertension of the newborn: a pilot randomized blinded study. Pediatrics, 2006, 117(4): 1077-1083.
12. Bifano EM, Hakanson DO, Hingre RV, et al. Prospective randomized controlled trial of conventional treatment or transport for ECMO in infants with persistent pulmonary hypertension (PPHN). Pediatr Res, 1992, 31(8): 196A.
13. O’Rourke PP, Crone RK, Vacanti JP, et al. Extracorporeal membrane oxygenation and conventional medical therapy in neonates with persistent pulmonary hypertension of the newborn: a prospective randomized study. Pediatrics, 1989, 84(6): 957-963.
14. Lorch SA, Cnaan A, Barnhart K. Cost-effectiveness of inhaled nitric oxide for the management of persistent pulmonary hypertension of the newborn. Pediatrics, 2004, 114(2): 417-426.
15. 杜立中, 魏克伦, 孙眉月. 新生儿持续肺动脉高压诊疗常规. 中华围产医学杂志, 2003, 6(1): 61-62.
16. Mugford M, Elbourne D, Field D. Extracorporeal membrane oxygenation for severe respiratory failure in newborn infants. Cochrane Database Syst Rev, 2008(3): CD001340.
17. Frostell C, Fratacci MD, Wain JC, et al. Inhaled nitric oxide. A selective pulmonary vasodilator reversing hypoxic pulmonary vasoconstriction. Circulation, 1991, 83(6): 2038-2047.
18. Tolsa JF, Cotting J, Sekarski N, et al. Magnesium sulphate as an alternative and safe treatment for severe persistent pulmonary hypertension of the newborn. Arch Dis Child Fetal Neonatal Ed, 1995, 72(3): F184-187.
19. Abu-Osba YK, Galal O, Manasra K, et al. Treatment of severe persistent pulmonary hypertension of the newborn with magnesium sulphate. Arch Dis Child, 1992, 67(1 Spec No): 31-35.
20. Young TE. Neofax. 19th ed. Raleigh: Acorn Publishing Inc, 2006: 136-146.

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《中国循证医学杂志》

一例新生儿胎粪吸入综合征合并肺动脉高压的循证治疗

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《中国循证医学杂志》

一例新生儿胎粪吸入综合征合并肺动脉高压的循证治疗

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