Efficacy And Safety Of Sildenafil Treatment In Persistent Pulmonary Hypertension Of The Newborn

Objective By comparing the efficacy and the safety of different doses of sildenafil in the treatment of persistent pulmonary hypertension of the newborn(PPHN),we try to seek for a more suitable and effective dose for sildenafil therapy.Methods Included 60 cases with persistent pulmonary hypertension of the newborn(PPHN)from Second Affiliated Hospital of Anhui Medical University neonatal intensive care unit in January 2014 ~ June 2016,Which are given clinical routine treatment involving positive cause of treatment,mechanical ventilation,prevention and treatment of infection and maintaining the stability of the body fluid environment,etc.According to different doses of sildenafil randomly divided into three groups: Group A given 0.5mg / kg,group B given 1mg / kg,group C given 2mg / kg,interval of 6 hours treated once through the nasogastric tube,observed one week,Compared the average pulmonary arterial pressure,oxygen saturation,blood oxygen partial pressure,arterial blood carbon dioxide partial pressure and the frequency of side effects in different groups before and after treatment,Organized data and tested with statistical methods.Results Total 60 cases,each group 20 cases,The average gestational age are respectively: group A 36.1 ± 4.1 weeks(male / female 9/11),group B 35.8 ± 3.9 weeks(male / female 12/8),group C 37.2 ± 4.3 weeks(male / female 10/10).Pulmonary arterial pressure and arterial blood carbon dioxide partial pressure of this three groups were obviously decreased,and the oxygen saturation and blood oxygen partial pressure were obviously increased after treatment with sildenafil,differences were statistically significant(P <0.01);Besides,Comparison between the three groups showed that sildenafil has a dose-dependent character in treatment of neonatal continuous pulmonary hypertension,within a given dose range,the dose higher,the effect more significant,Group B and group C were better than group A in clinical recovery indicators and the recovery time,and the difference was statistically significant.However,within a given dose range,the dose higher,the side effects occurred more,group C had the most adverse effects.Conclusion Sildenafil is an effective drug for the treatment of persistent pulmonary hypertension of the newborn,not only effectively reduce the pulmonary hypertension,and hardly affect the systemic systolic blood pressure,but also significantly improve hypoxemia and gas exchange function;However the dose higher,the side effects more,it is necessary to select the appropriate dose.