Effect and nursing of sildenafil combined with pulmonary surfactant on the treatment of newborn meconium aspiration syndrome children with persistence pulmonary hypertension

Abstract

Objective To explore the treatment effect of sildenafil combined with pulmonary surfactant （PS） on newborn meconium aspiration syndrome （ NMAS） children with persistence pulmonary hypertension （ PPH） , and to summarize the nursing experience .Methods Sixty NMAS children with PPH were chosen and randomly divided into the control group and the observation group according to the random number table , each with 30 cases. All children received the routine treatment including high frequency oscillation assisted ventilation , proper rehydration , antibiotics and so on , and the control group received the intratracheal instillation of PS, and the observation group received the sildenafil on the basis of PS .The oxygenation index （ OI ） , alveolar-arterial oxygen difference （ A-aDO2 ） and pulmonary artery pressure （ PAP） were compared between two groups before and after the treatment .Results The differences were found in the OI and A-aDO2 4 and 12 h after the treatment between two groups （P<0.01）; The OI was （11.7 ±177;2.8） in the observation group 36 h after the treatment, and was （19.1 ±177;3.4） in the control group, and the difference was statistically significant （t=9.202, P<0.01）; the A-aDO2 was （12.1 ±177;3.2）mmHg in the observation group, and was （27.6 ±177; 5.5）mmHg in the control group, and the difference was statistically significant （t=13.342, P<0.01）.The PAP was （40.4 ±177;10.7） mmHg in the observation group 24 ~36 h after the treatment, and was （49.3 ±177; 13.4）mmHg in the control group, and the difference was statistically significant （t=2.843, P<0.01）.No serious complications were found in two groups .Conclusions The sildenafil combined with PS , meanwhile, the respiratory tract nursing and the high frequency oscillation assisted ventilation airway nursing were well , can further enhance the treatment effect of NMAS combined with PPH . Key words: Newborn; Meconium aspiration syndrome; Pulmonary hypertension; Sildenafil; Pulmonary surfactant