重度肺动脉高压心脏直视术后急性肺损伤的防治研究  

Protective therapy of acute lung injury during cardiopulmonary bypass in patients with congenital heart disease associated with pulmonary hypertension

作　　者：徐克劲[1] 张世范[1] 吕国祯[1] 高秀峰[1] 刘惠萍[1] 吴学祥[1] 张希平[1] 刘维强[1] 

机构地区：[1]兰州军区兰州总医院胸外科,兰州730050

出　　处：《西北国防医学杂志》1999年第3期172-174,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：军队"九五"医药卫生科研基金

摘　　要：目的：探讨先心病合并重度肺动脉高压围手术期应用中药红景天合剂开展早期防治术后急性肺损伤的可能性。方法：根据均衡配比和肺动脉高压分级标准将拟行手术的病例随机分为防治组（ Ｅ Ｇ） 与常规处理对照组（ Ｃ Ｇ） 。 Ｅ Ｇ 在常规术前准备同时开始应用红景天合剂 Ｒ Ｃ Ｏ（ 术前７ ～１０ ｄ ，术后５ ～７ ｄ） 。 Ｃ Ｇ 于住院后只按常规方法进行处理，两组按对应时间点进行各项预设指标检查。结果： Ｅ Ｇ 多项指标优于 Ｃ Ｇ， Ｐ＜ ０ ．０５ 或 Ｐ＜ ０ ．０１ 。 Ａ Ｒ Ｄ Ｓ发生率和死亡率 Ｅ Ｇ 依次为１／２２（４ ．５ ％ ） ，０／１ ； Ｃ Ｇ为５／２０（２５ ％ ） ，２／５（４０ ％ ） 。结论：藏药红景天合剂可能对创伤性大手术并发 Ａ Ｒ Ｄ Ｓ有一定的预防作用和研究价值。Purpose: To observe the effects of the Chinese drug rhadiola therapy in the prevention of acute lung injury(ALI)/ARDS induced by cardiac operations of congenital heart disease(CHD) with serious pulmonary hypertension.Methods:According to the diagnosis and standard scaling of pulmonary hypertension, 42 patients were divided randomly into early preventive treatment group(EG) and routine treatment group(CG).Each group was selected by balance scale examination.In EG,both motheds of routine treatment and Chinese drug rhadiola compound(RCO) were used before and after operation.In CG,only same routine treatment was used.Results:PaO 2,AaDO 2 and other indicators of hemorrheology in EG were significantly satisfied than those in CG at all time points( P <0.05 or P <0.01).The complication rate and mortality rate of ARDS in EG were lesser than those in CG 1/22(4.5%),0/1 vs 5/20(25%),2/5(40%,respectively).Conclusion:Complication of ARDS might be prevented earlierly by using of Chinese drug RCO during cardiopulmonary bypass in patients with CHD associated with pulmonary hypertension.

关 键 词：肺动脉高压 红景天 心内直视术 肺损伤 

分 类 号：R654.206[医药卫生—外科学] R542.206[医药卫生—临床医学]