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目的探讨先天性心脏病(CHD)合并重度肺动脉高压(PH)术前应用前列地尔的意义。方法 56例CHD合并PH的患儿,术前予前列地尔100μg加入氯化钠注射液100mL中静脉微量泵泵入,0.02～0.05μg·kg~(-1)·min~(-1),每日持续用药8～10h,连续用药14～18d。对比分析用药前后的平均肺动脉压(mPAP)、平均体动脉压(mSAP)、周围动脉血氧分压(PaO_2)、血氧饱和度(SaO_2)和左心室射血分数(LVEF),并观察患儿不良反应情况。结果前列地尔治疗后,CHD合并重度PH患儿mPAP显著降低(P<0.01),而LVEF、SaO_2及PaO_2均不同程度提高(P<0.05),无严重不良反应发生。结论术前用前列地尔治疗后可明显改善CHD合并重度PH患儿的心、肺功能,提高手术的安全性。
Objective To investigate the application of prostaglandin in patients with congenital heart disease (CHD) complicated with severe pulmonary hypertension (PH). Methods Fifty - six children with CHD complicated with PH were enrolled in this study. Preoperative 100g of alprostadil plus sodium chloride injection was injected into the middle venous pump with a dose of 0.02 ~ 0.05μg · kg -1 · min -1, Continuous daily medication 8 ~ 10h, continuous medication 14 ~ 18d. The mean pulmonary artery pressure (mPAP), mean arterial pressure (mSAP), peripheral arterial oxygen pressure (PaO_2), oxygen saturation (SaO_2) and left ventricular ejection fraction (LVEF) were compared before and after treatment. Adverse reactions to children. Results After treatment with alprostadil, the mPAP in CHD patients with severe PH was significantly lower (P <0.01), while LVEF, SaO_2 and PaO_2 were increased to some extent (P <0.05). No serious adverse reactions occurred. Conclusion Preoperative alprostadil treatment can significantly improve CHD with severe PH in children with heart and lung function, improve the safety of surgery.