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Objective:To study the early use of inhaled nitric oxide (iNO) as a rescue therapy in extremely premature infants (EPIs) with refractory hypoxic respiratory failure (HRF).Methods:Between January 2021 and December 2021, EPIs with refractory HRF receiving iNO within the first week of life in our NICU were enrolled. Their clinical characteristics and outcomes were retrospectively analyzed.Results:A total of 11 EPIs were included with 5 males and 6 females. The median gestational age (GA) was 24(22.6, 25.2) weeks. The median birth weight (BW) was 580(490, 770) g. The most common primary diagnoses were moderate/severe respiratory distress syndrome (RDS) (5/11) and early-onset sepsis (3/11). The median age starting iNO therapy was 6.5(4.5, 34.0)h and the median duration of iNO was 24(12, 36)h. The median iNO starting dose was 5(5, 8) ppm and the therapeutic range was 5-20 ppm. Therapeutic efficacy was defined as ≥30% FiO 2 reduction after 6 h of iNO treatment. The treatment was effective in 8 cases. The oxygenation index (OI) decreased more than 10% from baseline 1 h after initiation in 9 patients and in all 11 patients after 12 h of iNO. The reduction of OI was more prominent in EPIs with a higher OI at baseline. Of the 11 patients, 8 survived, 1 died and 2 abandoned further treatments. Conclusions:As an early rescue therapy for EPIs with refractory HRF, iNO can improve oxygenation without obvious short-term adverse effects.
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Objective:To review the treatment experience of extremely premature infants (EPIs) with gestational age (GA) <23 weeks.Methods:From January to November 2021, EPIs with GA<23 weeks treated in our hospital was retrospectively analyzed.Results:A total of 3 patients with GA of 22 weeks were reviewed, including 2 boys and 1 girl. Their birth weight (BW) was 450~498 g. The duration of hospitalization was 112~126 d. The treatment included early "gentle" management strategies, respiratory management, anti-infection, patent ductus arteriosus treatment and parenteral + enteral nutrition. All 3 infants were discharged from the hospital without further oxygen therapy. All had satisfying oral feeding with no neurological sequelae on follow-up.Conclusions:Early "gentle" management is the key to successful treatment and good prognosis for EPIs with GA<23w
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Objective@#To compare the clinical effect of metoprolol combined with valsartan and nifedipine controlled release tablets in the treatment of primary hypertension complicated with coronary heart disease(CHD).@*Methods@#200 primary hypertension patients with CHD were selected, and they were randomly divided into observation group and control group according to the digital table, 100 cases in each group.The observation group was treated with metoprolol combined with valsartan, the control group was treated with nifedipine controlled release tablets.The clinical effect of the two groups was compared.@*Results@#Before treatment, the diastolic and systolic blood pressure of the control group were (106.8±12.3)mmHg and (173.4±22.8)mmHg, respectively, which of the observation group were (104.3±11.4)mmHg, (177.6±24.2)mmHg, respectively, the differences were not statistically significant between the two groups(t=1.265, 0.337, all P>0.05). The diastolic and systolic blood pressure after treatmentin of the observation group were (131.6±17.4)mmHg, (85.3±7.1)mmHg, respectively, and the total effective rate of the observation group was 93.0%(93/100), the improvement rate of angina symptoms of the observation group was 86.0%(86/100), which were significantly better than those of the control group[(131.6±17.4)mmHg, (85.3±7.1) mmHg, 68.0%(68/100), 63.0%(63/100)], the differences were statistically significant (t=5.229, 6.122, χ2=9.148, 7.224, all P<0.05).@*Conclusion@#The combination of metoprolol and valsartan has better effect in the treatment of primary hypertension complicated with CHD compared with nifedipine controlled release tablets.
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Objective To explore the effect of amiodarone combined with carvedilol in the treatment of patients with arrhythmia.Methods 90 patients with cardiac arrhythmia were selected .According to different treatment,the patients were divided into control group and observation group ,45 cases in each group.The control group was treated with amiodarone , the observation group was given amiodarone combined with carvedilol .The therapeutic effect of the two groups was observed .Results Before treatment , the systolic blood pressure [ ( 149 ± 11)mmHg vs.(151 ±14) mmHg)],diastolic blood pressure [(95 ±11) mmHg vs.(95 ±12) mmHg)],heart rate [(143 ±16)times/min vs.(141 ±18)times/min] between the two groups had no statistically significant differences (t =6.214, 1.907, 3.228, all P >0.05 ).After treatment, the effective rate ( 91.11％), cardioversion rate (88.89％),standard time to achieve effective treatment [(2.50 ±0.79) d],systolic blood pressure [(119 ± 12)mmHg],diastolic blood pressure[(78 ±12)mmHg],heart rate [(78 ±20)times/min] in the observation group were better than those in the control group [86.67％,75.56％,(5.62 ±3.16) d,(142 ±15) mmHg,(90 ± 13)mmHg,(99 ±23) times/min],and the differences between the two groups were statistically significant (χ2 =8.235,7.157,t =6.214,5.718,5.102,all P<0.05).Conclusion Carvedilol combined with amiodarone in the treatment of patients with abnormal heart rate can significantly improve the cardiac function ,suppress deterioration , and can be widely used in clinical treatment .