米力农治疗小儿先天性心脏病并急性心力衰竭的疗效

Milrinone Therapy for Acute Heart Failure in Infants with Congenital Heart Disease

目的:探讨米力农治疗小儿先天性心脏病并发急性心力衰竭的疗效及安全性。方法:选取2010年1月至2012年12月在我院就诊的先天性心脏病合并急性心力衰竭的患儿64例作为观察组,年龄3个月～2岁,平均8个月,经心脏彩超检查诊断为先天性心脏病,在常规洋地黄强心、呋塞米利尿以及卡托普利扩血管治疗基础上,予以米力农治疗;以同时期未予米力农治疗而只进行常规治疗的先天性心脏病合并急性心力衰竭的患儿53例作为对照组。观察治疗前后患儿心功能改善情况以及心脏彩超相关数据的改变情况。结果:观察组显效率64.1%,明显高于对照组的41.5%,差异有统计学意义(P<0.05),两组总有效率比较差异无统计学意义(P>0.05)。心脏彩超结果观察组治疗前后比较,每搏输出量、每分输出量、舒张末期左心房内径、左室短轴缩短百分率均得到改善(P<0.05),射血分数、舒张末期左心室内径改善更明显(P<0.01);与对照组比较,观察组治疗后的射血分数、舒张末期左心室内径(长轴)及舒张末期左心房内径改善更明显,两组比较差异有统计学意义(P<0.05)。结论:米力农小剂量短期维持治疗小儿先天性心脏病并发急性心力衰竭有效、安全。

Objective： To investigate the curative effect and safety of treatment for acute heart failure with congenital heart disease by milrinone. Methods ： The patients of three months to two years of age （ average eight months of age ） who diagnosed congenital heart disease by ultrasonic cardiogram were enrolled and given conventional therapy. 64 cases received milrinone additionally as theobservation group, while 53 cases were as the control group. The improvement of heart function and the changes of uhrasonic cardiogram data after treatment were observed. Result： The effective rate of improvement of heart function in the observation group （64.1% ） was higher than that in the control group （P〈0.05）. The ejection fraction, the left ventricular internal dimension of end-diastole （P〈0. 01 ）, stroke volume, minute cardiac output, the left auricle inner diameter at end-diastole, and the percentage of shortened left ventricular stub （P 〈 0.05 ） in the observation group were improved. The improvements of the ejection fraction, the left ventricular internal dimension at end-diastole, and the left auricle inner diameter at end-diastole after treatment in the observation group were better than those in the control group （P〈0.05）. Conclusions： It is utility and safety for treatment of acute heart failure with congenital heart disease by low dose and temporary milrinone injection.