【摘要】 目的运用超声引导双心房输注技术,通过左右心导管分别输注去氧肾上腺素和前列腺素E1,观察该方法对急性肺动脉高压犬肺损伤的保护作用。方法实验用杂种犬15只,不拘雌雄,体重9~13 kg,均分为3组,急性肺动脉高压模型建立后,A组通过Swan-Ganz漂浮导管至右心房给予前列腺素E1脂微球载体制剂20ng/(kg·min),通过超声引导,经股动脉逆行置入左心导管至左心房,给予去氧肾上腺素2μg/(kg·min);B组通过Swan-Ganz漂浮导管至右心房给予同样的两种药物和剂量;C组通过Swan-Ganz漂浮导管至右心房给予等体积的生理盐水。观察并记录各组犬在不同时间的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)、中心静脉压(CVP)、平均肺动脉压(MPAP)、肺毛细血管楔压(PCWP)和心排出量(CO),并计算出心指数(CI)、全肺阻力指数(PVRI)和体循环阻力指数(SVRI),并检测同时点的血浆乳酸脱氢酶(LDH3)。结果在超声引导下,可以成功地经股动脉放置左心导管至左心房,肺栓塞肺动脉高压模型建立成功,给予药物治疗后,与C组比较,A、B组T3~T5时段MPAP下降(P<0.05),与A组比较,B组T3~T5时段CI、体循环的MAP和SVRI下降(P<0.05),与C组比较,A、B组T4、T5时段LDH3下降(P<0.05)。结论通过超声引导双心房输注分别给予去氧肾上腺素和前列腺素E1能够有效地降低肺动脉压,同时改善急性肺动脉高压状态下肺脏灌注和缺血缺氧,起到一定的肺保护作用。更多还原

【Abstract】 Objective To evaluated the efficacy of ultrasound-guided biatrial infusion of phenylephrine and prostaglandin E1on the treatment of acute pulmonary hypertension(APH)-induced lung injury in dogs.Methods Fifteen mongrel dogs(9 ~ 13 kg),were allocated into three groups.After induction of APH,Lipo PGE1[20 ng/(kg· min) ] in atrium dextrum by Swan-Ganz floating catheter and given phenylephrine [2 μg/(kg·min) ]in atrium pulmonale by left cardiac catheter uncder ultrasound-guided through femoral artery to the left atrium or left ventricle were given in Group A;while same drugs through Swan-Ganz floating catheter were given in Group B and placebo saline were given in Group C.The haemodynamics,including HR,MAP,SpO2,CVP,MPAP and PCWP,and plasma LDH3were recorded for calculation of cardiac emissions(CO),cardiac index(CI),total pulmonary resistance index(PVRI) and systemic vascular resistance index(SVRI).Results APH model was successfully constructed.Left ventricular catheter was successfully placed through femoral artery to the left atrium under ultrasound guidance.Pulmonary artery pressures and LDH3 were significantly reduced in Group A and B when comparing with Group C(P < 0.05).CI circulation,MAP and PVRI were reduced in Group B when comparing with Group A(P < 0.05).Conclusion Ultrasound-guided biatrial infusion of phenylephrine and Lipo PGE1effectively reduces pulmonary hypertension and improves pulmonary perfusion,ischemia and hypoxia;thus produces protective effects on lung injury in APH.更多还原