摘要
目的分析前列地尔+高压氧(HBO)联合治疗对先天性心脏病(CHD)合并重度肺动脉高压(PAH)患儿的临床效果。方法分析2014年6月至2016年12月在温州市人民医院接受治疗的92例CHD伴重度PAH患儿的临床资料。根据治疗方式的不同,将入选患儿分成治疗组(常规治疗+HBO+前列地尔治疗,48例)和对照组(常规药物治疗,44例)。比较两组患儿的一般资料及入院时(T0)、手术治疗15d后(T1)及术后10d(T2)各时点的血流动力学[包括肺动脉平均压(MPAP)、平均体循环压(MSAP)、体循环阻力(SVR)、肺循环阻力(PVR)及肺动脉压/主动脉压(Pp/Ps)]等变化情况及动脉血氧饱和度(SaO_2)水平。结果两组患儿的一般资料无显著统计学差异(P>0.05)。治疗组患者的MPAP、PVR及Pp/Ps在T1时刻均低于治疗组,有统计学差异(t值分别为2.42、2.32、2.03,均P<0.05),在T2时刻进一步降低,有统计学差异(t值分别为2.06、2.12、2.25,均P<0.05),;而SaO_2在TI期明显上升(t=3.23,P<0.05),手术后显著升高(t=9.09,P<0.01),均有统计学意义。结论与单独药物治疗相比,前列地尔+HBO联合治疗CHB合并重度PAH患儿的临床疗效更为突出,降低MPAP和提升SaO_2的效果更为明显,用药时应注意相关事项。
Objective To analyze the clinical effect of alprostadil combined with hyperbaric oxygenation （HBO） on treating children with congenital heart disease （CHB） accompanied with severe pulmonary artery hypertension （PAH）.Methods Clinical data of 92 patients with CHB accompanied with severe PAH receiving treatment in Wenzhou People＇s Hospital from June 2014 to December 2016 were retrospectively analyzed.Patients were divided into treatment group （conventional therapy＋HBO＋alprostadil, 48 cases） and control group （conventional therapy, 44 cases） according to different treatment.The general information and hemodynamics indexes including mean pulmonary arterial pressure （MPAP）, mean systemic arterial pressure （MSAP）, systemic vascular resistance （SVP）, pulmonary vascular resistance （PVR）, pulmonary artery pressure/aortic pressure （Pp/Ps） and arterial blood oxygen saturation （SaO2） at admission （T0）, 15 days after surgery （T1） and 10 days after surgery （T2） were compared between two groups.Results The general information in two groups had no statistical difference （P〉0.05）.Compared to the control group, the values of MPAP, PVR and Pp/Ps at T1 were lower in the treatment group with statistical differences （t value was 2.42,2.32 and 2.03, respectively, all P〈0.05）.They decreased further at T2 with statistical differences （t value was 2.06, 2.12 and 2.25, respectively, all P〈0.05）.The levels of SaO2 at T1 （t=3.23,P〈0.05） and after operation （t=9.09,P〈0.01） were obviously higher, and the differences were statistically significant.Conclusion Compared to the treatment with simple drug, the treatment of alprostadil ＋HBO has better clinical effect on the patients with CHB accompanied with severe PAH.It can depress PAP and enhance SaO2.Pay attention to the related matters when using alprostadil.Interventions such as cardiac rehabilitation exercise and psychological health should be strengthened after operation.It＇s worth promoting.
作者
朱秀若
朱秀梅
张建华
朱宁
万诚
丁玲利
姜文兵
ZHU Xiu-ruo ZHU Xiu-mei ZHANG Jian-hua ZHU Ning WAN Cheng DING Ling-li JIANG Nv-bin(Wenzhou People＇ s Hospital, Wenzhou City Maternal and Child Health Care, Zhejiang Wenzhou 325000, China The Second Hospital Affiliated to Wenzhou Medical College, Yuying Children＇ s Hospital Affiliated to Wenzhou Medical College, Zhejiang Wenzhou 325000, China)
出处
《中国妇幼健康研究》
2017年第5期595-597,共3页
Chinese Journal of Woman and Child Health Research
