曲前列尼尔治疗先天性心脏病并重度肺动脉高压临床观察  

Clinical Observation on Traprostanil in the Treatment of Congenital Heart Disease Complicated with Severe Pulmonary Hypertension

作　　者：章云峰[1] 仇锦春[1] 许静[1] ZHANG Yunfeng;QIU Jinchun;XU Jing(Children's Hospital of Nanjing Medical University,Nanjing,Jiangsu,China 210008)

机构地区：[1]南京医科大学附属儿童医院

出　　处：《中国药业》2019年第24期61-63,共3页China Pharmaceuticals

基　　金：江苏省南京市卫生科技发展专项资金项目[YKK18147]

摘　　要：目的探讨曲前列尼尔治疗先天性心脏病(简称先心病)并重度肺动脉高压患儿的临床疗效。方法选取医院2015年1月至2016年12月收治的先心病并重度肺动脉高压患儿59例,按术后是否使用曲前列尼尔分为研究组(28例)和对照组(31例)。两组患儿均予常规治疗,术前口服枸橼酸西地那非片1周。手术均经正中切口,体外循环下行心内直视修补,术后常规方案维持循环稳定,继续口服枸橼酸西地那非片。研究组于手术完毕停止体外循环后加用曲前列尼尔注射液。结果与术前比较,两组患儿术后1 h和术后24 h肺动脉收缩压(PASP)、肺/体动脉收缩压比值(Pp/Ps)明显下降,且研究组患儿上述指标均明显低于对照组(P<0.05);两组患儿术后1 h和术后24 h动脉血氧分压(PaO2)明显上升,且研究组患儿上述指标明显高于对照组(P<0.05);研究组患儿术后气管插管时间和重症监护室停留时间较对照组明显缩短(P<0.05);研究组患儿不良反应发生率为10.71%(3/28)。结论曲前列尼尔治疗先心病并重度肺动脉高压患儿,可改善肺部氧合情况,缩短气管插管时间和重症监护室停留时间。Objective To investigate the efficacy of treprostinil in the treatment of congenital heart disease complicated with severe pulmonary hypertension.Methods Totally 59 patients with congenital heart disease complicated with severe pulmonary hypertension admitted to our hospital from January 2015 to December 2016 were selected and divided into the study group(n=28)and the control group(n=31)according to whether troprostil was used after operation.The children patients in the two groups were given routine treatment,and they took Sildenafil Citrate Tablets orally for 1 week before the operation.All the patients underwent open heart repair under cardiopulmonary bypass through the median incision.After the operation,the patients were treated with routine regimen to maintain circulation stability and continued to take Sildenafil Citrate Tablets.The patients in the study group were treated with Troprostil Injection after cardiopulmonary bypass.Results One hour and 24 hours after the operation,the pulmonary artery systolic pressure(PASP)and the ratio of pulmonary arterial pressure and systemic arteria pressure(Pp/Ps)in the two groups were significantly lower than those before the operation,and the imrovement of the above indexes in the study group were significantly lower than that in the control group(P<0.05).1 h and 24 h after the operation,the level of PaO2 in the two groups was significantly higher than that before the operation,and the improvement of the above index in the study group was significantly higher than that in the control group(P<0.05).The intubation time and ICU stay time in the study group were significantly shorter than those in the control group(P<0.05).The incidence of adverse reactions in the study group was 10.71%(3/28).Conclusion Traprostanil in the treatment of children patients with congenital heart disease complicated with severe pulmonary hypertension can improve pulmonary oxygenation,shorten intubation time and ICU stay time.

关 键 词：曲前列尼尔 重度肺动脉高压 先天性心脏病 临床疗效 小儿 

分 类 号：R969.4[医药卫生—药理学] R972[医药卫生—药学]