CAJ | 학술논문

目的探讨吸入一氧化氮(NO)治疗先天性心脏病术后肺动脉高压患儿的疗效.方法选择32例先天性心脏病术后传统治疗无效的、难治的、反应性肺动脉高压或肺动脉高压危象患儿,吸入NO(10～25)×10-6,定时记录各项血流动力学和呼吸功能指标,定期监测二氧化氮、高铁血红蛋白含量.结果吸入NO后,平均肺动脉压(mPAP)从(38.0±3.2)mm Hg(1 mm Hg=0.133 kPa)降至(28.0±2.1)mm Hg,肺血管阻力从(62.2±6.7)kPa/(L·S)降至(49.9±5.6)kPa/(L·S),氧合指数从(67.0±30.1)mm Hg升至(92.6±25.0)mm Hg,动脉血氧饱和度从0.78±0.14升至0.84±0.09,差异均有非常显著性(P＜0.01).吸入NO期间,二氧化氮和高铁血红蛋白含量均在安全范围.结论 NO可以明显降低先天性心脏病术后肺动脉压力和肺血管阻力,是一种安全且理想的肺血管扩张剂.
목적 탐토흡입일양화담(NO)치료선천성심장병술후폐동맥고압환인적료효.방법 선택32례선천성심장병술후전통치료무효적、난치적、반응성폐동맥고압혹폐동맥고압위상환인,흡입NO(10～25)×10-6,정시기록각항혈류동역학화호흡공능지표,정기감측이양화담、고철혈홍단백함량.결과 흡입NO후,평균폐동맥압(mPAP)종(38.0±3.2)mm Hg(1 mm Hg=0.133 kPa)강지(28.0±2.1)mm Hg,폐혈관조력종(62.2±6.7)kPa/(L·S)강지(49.9±5.6)kPa/(L·S),양합지수종(67.0±30.1)mm Hg승지(92.6±25.0)mm Hg,동맥혈양포화도종0.78±0.14승지0.84±0.09,차이균유비상현저성(P＜0.01).흡입NO기간,이양화담화고철혈홍단백함량균재안전범위.결론 NO가이명현강저선천성심장병술후폐동맥압력화폐혈관조력,시일충안전차이상적폐혈관확장제.
Objective To evaluate the effects of inhaled nitric oxide (iNO) in management of postoperative pulmonary hypertension in the patients with congenital heart disease. Methods Thirty-two children with refractory pulmonary hypertension or pulmonary hypertensive crisis after open heart operations for congenital heart disease were treated with iNO. The changes of hemodynamics were observed. Results In iNO therapy group,the mean pulmonary artery pressure(mPAP) decreased from (38.0 ±3.2) mm Hg to (28.0 ±2.1) mm Hg,pulmonary vascular resistance (PVR) decreased from (62.2 ±6.7) kPa/(L·S) to (49.9 ±5.6) kPa/(L·S) ,PaO2/FiO2increased from (67.0 ±30. 1 ) mm Hg to (92. 6 ±25.0) mm Hg,and arterial oxygen saturation increased from 0. 78 ±0. 14 to 0. 84 ±0. 09 respectively. No toxic side effect was observed.Conclusion iNO is effective, safe to reduce pulmonary hypertension. It may play an important role in the treatment of postoperative pulmonary hypertension or pulmonary hypertensive crisis in the patients with congenital heart disease.