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目的观察静脉注射地尔硫治疗先天性心脏病合并重度肺动脉高压的疗效。方法通过漂浮导管动态监测12例先天性心脏病合并重度肺动脉高压术后患者应用地尔硫(3~5μg.kg-1.min-1)持续静脉点滴,并记录应用地尔硫前、应用地尔硫后6h、试停呼吸机前、拔除气管插管后1h、24h的平均肺动脉压、平均动脉压、心率、每搏输出量、肺循环阻力、体循环阻力等指标的变化。结果12例患者无死亡,应用地尔硫后平均肺动脉压、肺循环阻力及心率显著降低,每搏输出量及平均动脉压显著增加,体循环阻力无明显改变,未发生肺高压危象。平均呼吸机辅助时间(88.7±50.1)h。结论静脉注射地尔硫能有效控制肺血管痉挛,从而降低肺动脉压,可用于治疗先天性心脏病合并重度肺动脉高压。
Objective To observe the efficacy of intravenous diltiazem in patients with congenital heart disease complicated with severe pulmonary hypertension. Methods Floating catheter was used to monitor continuous intravenous drip of diltiazem (3 ~ 5μg.kg-1.min-1) in 12 patients with congenital heart disease complicated with severe pulmonary hypertension. 6 h after Diltiazem, before stopping ventilator, 1 h after tracheal intubation, mean arterial pressure, mean arterial pressure, heart rate, stroke volume, pulmonary resistance, systemic resistance and other indicators of change. Results There was no death in 12 patients. The average pulmonary arterial pressure, pulmonary resistance and heart rate were significantly decreased after Diltiazem application. The stroke volume and mean arterial pressure were significantly increased. There was no significant change in systemic resistance and no pulmonary hypertension crisis. Mean ventilator assisted time (88.7 ± 50.1) h. Conclusion Diltiazem intravenously can effectively control pulmonary vasospasm, thereby reducing pulmonary artery pressure, can be used to treat congenital heart disease complicated with severe pulmonary hypertension.