硝普钠经肺动脉直接输注对肺动脉高压的疗效观察

Effect of sodium nitroprusside infused through pulmonary artery on the pulmonary artery hypertension

目的 观察硝普钠对二尖瓣置换术后肺动脉高压的疗效。方法 对二尖瓣置换术后具有肺动脉高压的患者 ,由颈内静脉或锁骨下静脉放置Swan -Ganz导管监测其血液动力学指标 ,采用硝普钠经肺动脉端直接输注进行治疗 ,观察硝普钠治疗前后上述血液动力学指标的变化情况。结果 采用硝普钠进行治疗后 ,患者的平均动脉血压 (MAP)、平均肺动脉压 (MPAP)、外周血管阻力指数 (SVRI)及肺血管阻力指数 (PVRI)较用药前明显下降 (P <0 0 5 ) ,而每搏输出量 (SV)、心输出量(CO)及心脏指数 (CI)较用药前明显增高 (P <0 0 5 )。结论 由肺动脉直接输注硝普钠可有效降低二尖瓣置换术后的肺动脉高压 。

Objective To investigate the effect of sodium nitroprusside on the pulmonary artery hypertension in the postoperation of mitarl valve replacement. Methods To monitor the hemodynamic changes of the patients with pulmonary artery hypertension underging mitral valve replacement, a pulmonary artery Swan Ganz thermodilution catheter was introduced throuth the internal jugular or subclavian vein into the pulmonary artery.investigatine the effect of sodium nitroprusside infused through pulmonary artery directly on hemodynamic changes. Results After administration of sodium nitroprusside, mean artery pressure, mean pulmonary artery pressure, systemic vascular resistance index and pulmonary vascular resistance index decreased significantly( P< 0 05). In conversely, the stroke volume, cardiac output and cardiac index increased significantly( P< 0 05). Concluions Sodium nitroprusside infused through pulmonaryartery can not only decrease pulmonaryartery hypertension but also increase the cardiac output in patients with pulmonary artery hypertension undergng mitral valve replacement.