曲前列尼尔在合并重度肺动脉高压先天性心脏病手术麻醉中的疗效分析  

Clinical efficacy of treprostinil used in anesthesia for surgical correction of congenital heart disease with severe pulmonary hypertension

作　　者：刘锴 肖文[1] 高扬 黄维勤[1] LIU Kai;XIAO Wen;Gao Yang;HUANG Weiqin(Department of Anesthesiology,Wuhan Asia Heart Hospital,Wuhan,Hubei 430022,China)

机构地区：[1]湖北省武汉亚洲心脏病医院麻醉科,湖北武汉430022

出　　处：《中国医学工程》2019年第7期38-41,共4页China Medical Engineering

摘　　要：目的探索曲前列尼尔在合并重度肺动脉高压先天性心脏病围术期麻醉管理中的应用及疗效。方法回顾性分析该院2015年1月至2018年6月行外科手术的97例合并重度肺动脉高压的房间隔缺损患者,根据围术期有无使用曲前列尼尔分为试验组和对照组,试验组29例,对照组68例,比较两组的临床资料。结果两组术前肺动脉压力、阻力、左心室大小及射血分数(EF)比较差异均无统计学意义(P>0.05)。试验组术后的平均肺动脉压力(51±19)mmHg明显低于对照组的(83±21)mmHg,差异有统计学意义(t=3.020,P=0.005)。试验组术后的气管插管时间也低于对照组[(10.3±3.5)h vs.(16.6±5.7)h,t=2.200,P=0.040]。试验组术后的去甲肾上腺素使用剂量及重症监护室停留时间均低于对照组(P<0.05)。该研究无麻醉意外和麻醉死亡,两组的麻醉不良事件发生率差异无统计学意义(χ^2=0.335,P=0.563)。结论曲前列尼尔可降低围术期肺动脉压力及手术风险,用于重度肺动脉高压先天性心脏病的麻醉管理是安全有效的。【Objective】To investigate the clinical efficacy of treprostinil used in anesthesia for surgical correction of congenital heart disease with severe pulmonary hypertension.【Methods】The hospitalized cases of atrial septal defect with severe pulmonary hypertension from Jan.2015 to Jun.2018 were included in the study.The cases were divided into experimental group(n=29)and control group(n=68)according to the application of treprostinil during anesthesia.The clinical data were recorded,including pulmonary artery pressure(PAP),total pulmonary resistance(TPR),endotracheal intubation time,duration of ICU stay and so on.【Results】There were no statistical differences in PAP,TPR,left ventricular size and ejection fraction between the two groups before operation(all P>0.05).The mean PAP of the experimental group was(51±19)mmHg post operation,which was(83±21)mmHg in the control group;the difference was significant(t=3.020,P=0.005).The endotracheal intubation time of the experimental group was shorter than that of the control group[(10.3±3.5)h vs.(16.6±5.7)h,t=2.200,P=0.040].The noradrenaline dose and duration of ICU stay of the experimental group were lower than those of the control group post operation(all P<0.05).There was no anaesthesia accident and death.There was no statistical difference in the adverse event of anaesthesia between the two groups(χ^2=0.335,P=0.563).【Conclusion】Application of treprostinil is valid to decrease PAP and surgical risk in anesthesia for surgical correction of congenital heart disease with severe pulmonary hypertension.

关 键 词：曲前列尼尔 先天性心脏病 肺动脉高压 麻醉 手术 

分 类 号：R541.1[医药卫生—心血管疾病]