米力农对法洛四联征矫治术后低心排患者血液动力学的影响

Hemodynamic Effects of Milrinone in Treatment of Lower Cardiac Output After TCTF

目的：评价国产米力农（milrinone）对法洛四联征心内矫治术后低心排患儿血液动力学改变的临床效果。方法：20例行法洛四联征心内矫治术患者，随机分为两组：M组，米力农50μg／kg静注，以每分钟0．5μg／kg的速度维持；C组（对照组），等量生理盐水。观察给药前、给药后5、15、30、60min两组HR、MAP、PCWP、CI、SVR、PVR、SVI和LVSW1的变化。结果：M组给药后CI、SVI、LVSW1明显增高（P〈0．05），PCWP、SVR明显降低（P〈0．05），C组上述数据给药后无明显变化（P〉0．05）。与C组比较，M组CI给药后5min增高极显著（P〈0．01），30min仍显著增高（P〈0、05），PCWP给药后5～60min显著降低（P〈0．05），SVR给药后15min降低极显著（P〈0．01），30min仍显著降低（P〈0．05）。结论：米力农可显著增加心脏指数，降低前、后负荷。

Objective：To evaluate the hemodynamic effects of milrinone on lower cardiac output in children after TCTF. Methods： 20 children undergoing TCTF were randomly divided into two group ： M group with intravenously milrinone in dosage of 50μg/kg bodyweight and maitenanee dosage of 0.5mg/kg/min;C group （control group） with the same dosage of normal sodium. The changes of HR, MAP, PCWP, CI, SVR, PVR, SVI and LVSWI before and at 5mins, 14mins,30mins and 60mins after administration in two groups were observed. Results：In M group, the level of CI,SVI and LVSWI was increascd and that of PCWP and SVR was decreased after administration （ P 〈 0.05）. There was no above changes in C group （ P 〉0.05）. Compared with C group, the level of CI in M group was markedy significantly increased at 5 rains after administration （ P 〈 0.01）, and still increased at 30 rains after administration （P 〈 0.05） ;the level of PCWP was significantly decreased from 5 rains to 30 rains after administration （P 〈 0.05） ;the level of SVR was markedly significantly decreased at 15 rains （P〈 0.01） and constantly decreased at 30 rains after administration （ P 〈 0.05）. Conclusion： Milrinone can effectively improve cardiac index and lower carediac preload and afterload.