前列腺素E_1在风湿性心脏病并肺动脉高压围手术期应用

The perioperative application of prostaglandin E_1 for patients with rheumatic heart diease associated with pulmonary hypertension

目的:观察前列腺素E1(PGE1)在风湿性心脏病风心病并肺动脉高压围手术期中对血液动力学、术后并发症和()生存率的影响。方法:回顾性对照分析研究例风心病并肺动脉高压患者在我院行瓣膜置换术病人。组例(年月225A10819921～年月);组例(年月～年月),组术前静脉给小剂量前列腺素19971B1171997120006BE1(PGE1,～10ng/kg/min20ng/kg/),μ,术前周;术后同样用法周。其它治疗方案同组。min100g/d21A结果:PGE1具有选择性降低肺动脉压,改善心功能,减少术后并发症,提高术后生存率等作用。结论:PGE1在风心病并肺动脉高压围手术期中具有较理想的药理效果和临床作用。

Objective: To observe perioperative hemodynamics and postoperative deaths and complications after prostaglandin E1 (PGE1) administration in patients with rheumatic heart diease associated with pulmonary hypertension. Methods: The 225 valve replacement cases with rheumatic heart disease associated with pulmonary hypertension were collected and analyzed retrospectively. Those cases were divided into two groups: in group A there were 108 cases between Jan 1992 and Jan 1997, in group B there were 117 cases beween Jan 1997 and Jun 2000. To group B, continuous intravenous drip of small dose PGE1 was given at a speed between 10 ng/kg/min and 20 ng/kg/min, 100μg daily for two weeks before cardiac surgery, the same way for one week after cardiac surgery,the other treatment was the same as group A. Results: Small dose PGE1 not only can decrease pulmonary artery pressure significantly, but also improve cardiac function and decrease postoperative complications and deaths. Conclusion: PGE1 could play important role in the perioperative valve replacement of rheumatic heart diease associated with pulmonary hypertension.