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Application of prostaglandin E1 to ventricular septal defect and pulmonary hypertension in infants
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF PEDIATRIC SURGERY
- Issue:
- 4
- DOI:
- 10.3760/cma.j.issn.0253-3006.2004.04.017
- Key Word:
- 前列腺素E;室间隔缺损;高血压,肺性
Abstract： 目的探讨术前应用前列腺素E1(PGE1)对室间隔缺损并肺高压婴儿,增强心功能,降低肺动脉及肺小动脉阻力,提高手术耐受性的意义.方法本组18例 ,男13例,女5例.年龄5个月～6岁平均(29.67±23.14)个月.术前经右心导管测量右房、肺动脉、肺小动脉压力及相应部位的血氧含量,依Fick's公式分别计算出体循环、肺循环血流量及分流量,肺小动脉阻力、肺总阻力.选取Pp/Ps>0.45者为研究对象.术前给予静滴PGE1 14d,观察患儿用药后气急、肺部叮罗音的改变.对比根治手术中所测量肺动脉及肺小动脉压力,再次计算出上述各项数据.结果用药后肺动脉压、肺小动脉压、Pp/Ps、全肺阻力、肺小动脉阻力等均有明显下降;在心内分流量及体循环压力基本不变情况下,左、右心排量明显增加.全组病例术后均治愈.随访2年患儿生长发育良好.结论 PGE1是一种强有力的血管扩张剂,能直接扩张肺动脉, 降低肺动脉、肺小动脉压力和肺循环阻力,提高左右心输出量,改善心功能.术前用药可改善患儿心肺功能,增加对体外循环及手术的耐受性,渡过术后肺动脉高压危险期及提高治愈率.
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