外源性磷酸肌酸钠对法洛四联症根治术后血流动力学和心功能的影响

Effects of exogenous creatine phosphate on the hemodynamic and cardiac function in children with Tetralogy of Fallot after radical operation

目的 观察外源性磷酸肌酸 (CP)对法洛四联症 (TOF)病儿根治术后血流动力学和心功能的影响。方法 35例TOF病儿随机分为常规组 (2 0例 )和CP组 (15例 ,CP 1g 次 ,q 12h× 3～ 5d ,静脉滴注 ) ;应用超声心动图和肺动脉热稀释导管法测定TOF病儿心功能及血流动力学参数。结果 治疗后CP组心功能参数 (CI、FS、EF、mVcfc、ESWS、ΔT、左右室E A、右室VTIe VTIa)和血流动力学参数 (PVRI、SVRI、Rp Rs、HR、CI、SI、LVSWI和RVSWI)明显改善 ,且治疗前、后的差值明显高于常规组 ;常规组仅CI、LVSWI和RVSWI明显改善。CP组病儿拔管时间、ICU停留时间、正性肌力药应用时间均较常规组明显缩短 (P <0 0 1)。结论 外源性CP可明显改善TOF病儿的心功能和血流动力学状态 。

Objective: To evaluate the effects of exogenous creatine phosphate(CP) on the hemodynamic and cardiac function in children with Tetralogy of Fallot (TOF)after radical operation. Methods: Thirty five children with TOF were randomly divided into two groups: conventional (n=20) and CP (n=15, 2 0 g CP daily for 3～5 days). The cardiac function and hemodynamic parameters were determined by ECHO and thermodilution catheter. Results: After treatment, the cardiac function (CI, FS, EF, mVcfc, ESWS, ΔT, E/A of right and left ventricle, and VTIe/VTIa of right ventricle) and hemodynamic(PVRI, SVRI, Rp/Rs, HR, CI, SI, LVSWI, and RVSW) parameters in CP group were improved significantly,and the difference values of above index before and after treatment increased significantly compared to those of conventional group. Only CI, LVSWI and RVSWI improved in conventional group. The extubation time, the ICU stay time, and the time of administrating inotropic drugs intravenously in CP group were decreased significantly when compared to those of conventional group. Conclusion: Exogenous creatine phosphate could significantly improve hemodynamic states and cardiac function in children with TOF and shorten the time of postoperative recovery.