NO吸入在法洛四联症根治手术后的应用-东南大学学报医学版

NO吸入在法洛四联症根治手术后的应用

单位：徐州医学院附属医院,胸心外科,江苏,徐州,221002

分类号：R541.1, R452

出版年·卷·期（页码）：2005·24·第二期（75-77）

摘要：

目的:评价小剂量吸入一氧化氮(NO)对法洛四联症根治术后右心功能不全和低氧血症的治疗作用.方法:24例先天性心脏病法洛四联症患者,手术后吸入百万分之4.0 NO,分别于吸入前后不同时间监测各项血流动力学和呼吸功能指标,并于吸入结束时测量血小板浓度.结果:吸入NO后,中心静脉压从(21.9±4.8)mmHg(1mmHg=0.133 kPa)降至(14.8±5.6)mmHg;气道峰值压自(28.6±5.3)cmH2O(1 cmH2O=0.092kPa)降低至(17.4±5.3)cmH2O;在吸入氧浓度不变的情况下,动脉氧分压自(88.4±11.6)mmHg升高至(139.0±10.1)mmHg;血小板无明显减少.结论:NO作为一种选择性血管扩张剂,小剂量吸入用于法洛四联症根治术后患者可改善其右心功能和氧合功能,并可提高肺顺应性,降低机械通气时气道峰值压,而在治疗期内无明显毒副作用.

Objective To evaluate the effects of inhaled nitric oxide in patients after surgical correction of tetralogy of Fallot.Method Inhaled nitric oxide 4.0×10 -6 was administered in 24 patients after surgical correction of tetralogy of Fallot.Results In inhaled nitric oxide therapy group central venous pressure was decreased from(21.9±4.8)mmHg (1-mmHg= 0.133-kPa) to (14.8±5.6)mmHg(P<0.05),and peak pressure of airway from (28.6±5.3)cmH_2O (1-cmH_2O=0.098-kPa) to (17.4±5.3)cmH_2O(P<0.05), respectively.Simultaneously,when the concentration of inhaled oxygen kept the same,arterial oxygen pressure improved from (88.4±11.6)mmHg to (139.0±10.1)mmHg. No toxic side effect was observed.Conclusion Inhaled nitric oxide may play an important role in the mangement of right heart failure and hypoxemia in the early postoperative period after surgical correction of tetralogy of Fallot.

参考文献：

[1] BOOKER P D, PROSSER D P, FRANKS R. Nitric oxide in the treatment of acute right ventricular failure after surgical correction of tetralogy of Fallot, 1996(7)
[2] OING M, SCHNMACHER K, HEISE R. Intramyocardial synthesis of pro-and anti-inflammatory cytokines in infants with congenital cardiac defects. 2003(12). doi:10.1016/S0735-1097(3)00477-7
[3] KOMAI H, NAITO Y, AIMI Y. Nitric oxide synthase expression in lungs of pulmonary hypertensive patients with heart disease, 2001(1)
[4] 樊满齐, 邹霞英, 翁如萍. 吸入一氧化氮对急性肺损伤大鼠细胞间黏附分子-1表达的影响. 中华内科杂志2000(1)
[5] SYDOW M, BRISTOW F, ZINSERLING J. Variation of nitric oxide concentration during inspiration. 1997(2). doi:10.1097/00003246-199702000-00028
[6] 张春, 姜立清, 李小民. 急诊经皮冠状动脉腔内成形术患者血内皮和一氧化氮变化及意义. 中国危重病急救医学2002(4)
[7] 周涛, 陈贤楠, 樊雪梅. 高频振荡通气结合一氧化氮吸入治疗大鼠急性肺损伤的试验研究. 中华儿科杂志2002(1)

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录