NO吸入在法洛四联症根治手术后的应用  

Inhaled nitric oxide in patients after surgical correction of tetralogy of Fallot

作　　者：王国祥[1] 赵文静[1] 孟雷[1] 胡波[1] 葛蕾[1] 

机构地区：[1]徐州医学院附属医院胸心外科,江苏徐州221002

出　　处：《东南大学学报（医学版）》2005年第2期75-77,共3页Journal of Southeast University(Medical Science Edition)

摘　　要：目的 :评价小剂量吸入一氧化氮 (NO)对法洛四联症根治术后右心功能不全和低氧血症的治疗作用。方法 :2 4例先天性心脏病法洛四联症患者 ,手术后吸入百万分之 4.0NO ,分别于吸入前后不同时间监测各项血流动力学和呼吸功能指标 ,并于吸入结束时测量血小板浓度。结果 :吸入NO后 ,中心静脉压从 (2 1.9± 4.8)mmHg(1mmHg =0 .13 3kPa)降至 (14 .8± 5 .6)mmHg ;气道峰值压自 (2 8.6± 5 .3 )cmH2 O(1cmH2 O =0 .0 98kPa)降低至 (17.4± 5 .3 )cmH2 O ;在吸入氧浓度不变的情况下 ,动脉氧分压自 (88.4± 11.6)mmHg升高至 (13 9.0± 10 .1)mmHg ;血小板无明显减少。 结论 :NO作为一种选择性血管扩张剂 ,小剂量吸入用于法洛四联症根治术后患者可改善其右心功能和氧合功能 ,并可提高肺顺应性 ,降低机械通气时气道峰值压 ,而在治疗期内无明显毒副作用。Objective To evaluate the effects of inhaled nitric oxide in patients after surgical correction of tetralogy of Fallot.Method Inhaled nitric oxide 4.0×10 -6 was administered in 24 patients after surgical correction of tetralogy of Fallot.Results In inhaled nitric oxide therapy group central venous pressure was decreased from(21.9±4.8)mmHg (1-mmHg= 0.133-kPa) to (14.8±5.6)mmHg(P<0.05),and peak pressure of airway from (28.6±5.3)cmH_2O (1-cmH_2O=0.098-kPa) to (17.4±5.3)cmH_2O(P<0.05), respectively.Simultaneously,when the concentration of inhaled oxygen kept the same,arterial oxygen pressure improved from (88.4±11.6)mmHg to (139.0±10.1)mmHg. No toxic side effect was observed.Conclusion Inhaled nitric oxide may play an important role in the mangement of right heart failure and hypoxemia in the early postoperative period after surgical correction of tetralogy of Fallot.

关 键 词：吸入 法洛四联症 根治手术 根治术后 血小板 患者 小剂量 结论 目的 情况 

分 类 号：R725[医药卫生—儿科] R737[医药卫生—临床医学]