婴儿重症心内膜心肌病致泵及呼吸衰竭的治疗  

TREATMENT OF PUMP AND RESPIRATO-RY FAILURE DUE TO SEVERE INFANTILECARDIOMYOPATHY

作　　者：张宏艳[1] 范崇济[1] 张巧芳[1] 李秀英[1] 邢淑华[1] 潘永祜[1] 

机构地区：[1]天津市儿童医院内科

出　　处：《中华儿科杂志》1995年第2期78-79,共2页Chinese Journal of Pediatrics

摘　　要：治疗３７例心内膜心肌病致泵衰竭患儿。年龄１～９个月。使用多巴胺２～１０μｇ·ｍｉｎ￣（－１）／ｋｇ及硝普钠１～５μｇ·ｍｉｎ￣（－１）／ｋｇ治疗，用药时间１２～７２小时，同时吸氧、限制入量及适当纠正代谢性酸中毒，休克缓解后及时使用利尿剂并使其洋地黄化。１５例并发Ｉ型呼吸衰竭者加用鼻塞持续正压通气（ＣＰＡＰ）治疗。ＦｉＯ＿２０．４～０．８，压力０．３８～０．７８ｋＰａ（４～８ｃｍＨ＿２Ｏ），使用时间１２～１０９小时。１例合并ＤＩＣ，加用肝素及冷沉淀物，５例抽搐加用镇静剂及小量甘露醇。结果是除死亡３例，自动出院１例外，余３３例全部恢复。提示血管扩张剂及鼻塞ＣＰＡＰ可迅速改善微循环及心肺功能。rom 1988～1993 , 37 cases, aged 1～9 months,with pump failure due to cardiomyopathy were treatedwith dopamine 2～10μg/kg. min and soduim nitroprus-side 1～5μg/kg. min for 12～72 hours. Meanwhile,oxygen inhalation , restriction of fluid intake and appro-priate correction of metabolic acidosis with sodium bi-carbonate were applied to them after they were relievedfrom shock, diuretic therapy and digilalization wereemployed. Fifteen cases complicated with type I respi-ratory failure underwent rhinobyon CPAP, with FiO_20. 4～0. 8 , pressure 0. 382～0. 784 kpa (4～8 cmH_2O)for 12～1 09 hours. Under such circumstances , DIC oc-curred in one and convulsion in five cases, in whomheparin , cryoprecipitate , anticonvulsants and smalldose manitol were added, respectively. Three casesdied and others others recovered. Vasodilator and rhi-nobyon CPAP may quickly improve peripheral circula-tion and the functions of heart and lungs.

关 键 词：心肌病 呼吸功能不全 呼吸衰竭 药物疗法 婴儿 

分 类 号：R725.422[医药卫生—儿科] R725.638[医药卫生—临床医学]