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|本期目录/Table of Contents|

高原地区先天性心脏病并发重度肺动脉高压的围术期管理

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第1期
页码:
88-091
栏目:
临床研究
出版日期:
2014-09-25

文章信息/Info

Title:
Perioperative management of congenital heart disease complicated with severe pulmonary artery hypertension in plateau areas
作者:
邬晓臣1; 岳 琴1; 张近宝1; 赵 恒2; 辛 东1; 李运明1; 欧阳辉1
(成都军区总医院：1.心血管外科，2.超声科,四川 成都 610083)
Author(s):
WU Xiao-chen1;  YUE Qin1;  ZHANG Jin-bao1;  ZHAO Heng2;  XIN Dong1;  LI Yun-ming1;  OUYANG Hui1
(1.Division of Cardiovascular Surgery, 2.Division of Ultrasound, General Hospital, Chengdu Military Area Command, Chengdu 610083, Sichuan, China)
关键词:
高原; 心脏病; 先天性; 重度肺动脉高压; 一氧化氮
Keywords:
plateau;  heart disease;  congenital;  pulmonary artery hypertension;  nitric oxide
分类号:
R541.1
DOI:
-
文献标识码:
A
摘要:
目的:探讨降低高原地区先天性心脏病并发肺动脉高压患者围术期并发症和手术死亡率的策略，评估吸入一氧化氮（NO)在先天性心脏病并发重度肺动脉高压患儿围术期的治疗效果。方法： 回顾性分析2009年6月~2012年12月我院收治的31例高原地区先天性心脏病并发重度肺动脉高压患者围术期管理经验，分析其术前、术中和术后等治疗因素对患者预后的影响，以及术后患者吸入NO 前后的心率、平均动脉压、中心静脉压、动态肺顺应性及氧合指数的变化。结果： 1例患者死亡，其余30 例患者在经过严格围术期管理及吸入NO 治疗后，心率、血压无明显改变，平均超声肺动脉压力、动态肺顺应性、氧合指数比治疗前明显改善，有统计学意义。结论： 严密的围术期管理及NO吸入治疗对治疗高原地区先天性心脏病并发重度肺动脉高压患者具有较好的临床效果。
Abstract:
AIM:To explore the perioperative management of severe pulmonary artery hypertension (PAH) of congenital heart disease to decrease complication ratio and mortality in plateau areas and evaluate the treatment effect of inhaled nitric oxide (iNO). METHODS: Clinical data such as heart rate, mean arterial blood pressure, central venous pressure, pulmonary dynamic compliance and oxygenation index of 31 patients treated with iNO from June 2009 to December 2012 were analyzed retrospectively. RESULTS: After perioperative management including iNO treatment, one patient died (3.25%) and pulmonary dynamic compliance and oxygenation index in the other 30 patients increased significantly (P<0.05). Average ultrasonic pulmonary artery pressure (SPAP) decreased significantly (P<0.05). CONCLUSION: Appropriate perioperative management and NO inhalation are effective in treatment of CHD patients with PAH in plateau areas.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2014-01-21.
基金项目：成都军区十二五基金课题资助（C12039）
通讯作者：欧阳辉，副主任医师，主要从事高原肺动脉高压外科治疗研究Email：nowwilson@yeah.net
作者简介：邬晓臣，主治医师，博士Email：wuxiaochen1981@sina.cn
更新日期/Last Update: 2015-01-20