【摘要】 目的　观察先天性心脏病合并重度肺动脉高压（ＰＨ）患者围术期血液动力学的变化。方法　２０ 例先天性心脏病合并重度肺动脉高压患者以前列腺素Ｅ１ 应用不同时机分对照组和试验组，每组１０例。试验组在体外循环开始后从中心静脉持续泵注前列腺素Ｅ１２０ｎｇ·ｋｇ－ １ ·ｍ ｉｎ－ １；对照组在体外循环中，开放升主动脉后开始用前列腺素Ｅ１ 。观察围术期平均动脉压（ＭＡＰ）、平均肺动脉压（ＰＡＰ）、动脉压与肺动脉压之比（ＰＰ／ＰＳ）、心脏指数（ＣＩ）、肺阻力指数（ＰＶＲＩ）、体循环阻力指数（ＳＶＲＩ）的动态变化。结果　体外循环后各时点的肺动脉压力与主动脉压力之比较术前显著降低，（Ｐ＜ ０．０１）。肺阻力指数和体循环阻力指数在体外循环后逐渐升高，试验组肺阻力指数在升主动脉开放后６ 小时显著低于对照组，（Ｐ＜ ０．０１）。试验组心指数在开放循环后２～４ 小时高于对照组，（Ｐ＜０．０５）。结论　重度肺动脉高压心内畸形矫正手术中，体外循环开始即应用前列泉素Ｅ１ 的效果优于传统的开放升主动脉后给药的效果。更多还原

【Abstract】 Objective To observe perioperative hemodynamics after prostaglandin E 1 (PGE 1) administration in patients with congenital heart disease complicated by pulmonary hypertention during open heart surgery.Methods Twenty patients with congenital heart disease complicated by pulmonary hypertention, were divided randomly into control and test groups (n=10 ,either group). In control group PGE 1 was infused at rate of 20 ng.kg -1 .min -1 after opening aortic clamp, in test group PGE 1 was administered at the same rate after the begining of cardiopulmonary bypass(CPB).Mean pulmonary pressure (MPP) ,mean arterial pressure(MAP), pulmonary vascular resistance index(PVRI),systemic vascular resistance index(SVRI),and cardiac index(CI) were monitored during surgery.Results At the end of CPB ,MPP decreased as compared with that before CPB (P<0.05),PVRI was markedly lower in test group than that in control group (P<0.05). CI was significantly higher 4h and 6h after opening aortic clamp in test group than that in control group (P<0.05).Conclusion Infused immediately after begining of CPB, PGE 1 can produce better therapeutic effect than after opening aortic clamp.更多还原