CAJ | 학술논문

目的观察前列地尔脂微球载体制剂对冠状动脉搭桥术后患者心肺功能的影响.方法选取我院60例冠状动脉粥样硬化性心脏病(简称冠心病)患者,随机分为观察组和对照组,每组30例,两组患者术后均给予抗炎、营养心肌及机械通气等基础治疗,观察组术后静脉缓慢滴注稀释至30 ml生理盐水的前列地尔10μg,3次/天,共2d.检测两组患者术后0.5、6.0、12.0h动脉血氧分压(PaO2)及氧合指数(PaO2/FiO2)的变化,应用右心漂浮导管检测两组患者术后48h右心室射血分数(RVEF)、肺循环阻力(PVRI)的变化.结果给药前(术后0.5 h):观察组PaO2为(82.3±8.4) mmHg(1 mmHg =0.133 kPa)与对照组的(83.1±8.5) mmHg,观察组(PaO2/FiO2)为(212.8 ±10.4) mmHg,与对照组(214.3±10.7) mmHg比较,差异无统计学意义(P＞0.05);给药后(术后6.0、12.0 h):观察组PaO2为(96.0±9.8)、(108.0±10.6) mmHg,与对照组(84.3±6.1)、(86.7 ±7.3) mmHg比较,观察组(PaO2/FiO2)为(248.6±18.9)、(280.9±34.8)mmHg与对照组(220.5±16.1)、(245.9±28.2) mmHg比较,差异有统计学意义(P＜0.01);术后48.0 h:观察组RVEF(0.53±0.05)与对照组(0.46±0.04)比较,观察组PVRI[(203±28) ml]与对照组[(235±33) ml]比较有显著改善(P＜0.05).结论前列地尔脂微球载体制剂可提高冠状动脉搭桥术后患者PaO2及PaO2/FiO2,改善患者心功能,提高患者氧合代谢,有助于冠状动脉搭桥术患者术后心肺功能的恢复.
목적 관찰전렬지이지미구재체제제대관상동맥탑교술후환자심폐공능적영향.방법 선취아원60례관상동맥죽양경화성심장병(간칭관심병)환자,수궤분위관찰조화대조조,매조30례,량조환자술후균급여항염、영양심기급궤계통기등기출치료,관찰조술후정맥완만적주희석지30 ml생리염수적전렬지이10μg,3차/천,공2d.검측량조환자술후0.5、6.0、12.0h동맥혈양분압(PaO2)급양합지수(PaO2/FiO2)적변화,응용우심표부도관검측량조환자술후48h우심실사혈분수(RVEF)、폐순배조력(PVRI)적변화.결과 급약전(술후0.5 h):관찰조PaO2위(82.3±8.4) mmHg(1 mmHg =0.133 kPa)여대조조적(83.1±8.5) mmHg,관찰조(PaO2/FiO2)위(212.8 ±10.4) mmHg,여대조조(214.3±10.7) mmHg비교,차이무통계학의의(P＞0.05);급약후(술후6.0、12.0 h):관찰조PaO2위(96.0±9.8)、(108.0±10.6) mmHg,여대조조(84.3±6.1)、(86.7 ±7.3) mmHg비교,관찰조(PaO2/FiO2)위(248.6±18.9)、(280.9±34.8)mmHg여대조조(220.5±16.1)、(245.9±28.2) mmHg비교,차이유통계학의의(P＜0.01);술후48.0 h:관찰조RVEF(0.53±0.05)여대조조(0.46±0.04)비교,관찰조PVRI[(203±28) ml]여대조조[(235±33) ml]비교유현저개선(P＜0.05).결론 전렬지이지미구재체제제가제고관상동맥탑교술후환자PaO2급PaO2/FiO2,개선환자심공능,제고환자양합대사,유조우관상동맥탑교술환자술후심폐공능적회복.
Objective To investigate the effect of alprostadil on the cardio-pulmonary function of the patients after coronary artery bypass graft (CABG) by using Liposome prostaglandin.Methods Sixty cases of CAD were evenly divided into two groups:observation group and control group.Both groups were given the basic treatments such as anti-inflammation,mechanical ventilation,etc.Liposome prostaglandin was intravenously injected after surgery in control group,10 μg,thrice every day for 2 days.The changes of PaO2,and PaO2/FiO2 were examined at 0.5,6.0,and 12.0 h after surgery.The changes in RVEF and PVRI at 48.0 h after surgery were measured by using the right cardiac catheterization techniques.Results Before alprostadil administration and at 0.5 h after surgery,the PaO2 value was (82.3 ± 8.4) mmHg (1 mmHg=0.133 kPa) in observation group and (83.1 ±8.5) mmHg in control group,and the PaO2/FiO2 value was (212.8 ± 10.4) mmHg in observation group and (214.3 ± 10.7) mmHg in control group (P ＞0.05).After alprostadil administration and at 6.0 and 12.0 h after surgery,the PaO2 value was (96.0±9.8) and (108.0 ± 10.6) mmHg in observation group and (84.3 ±6.1) and (86.7 ±7.3) mmHgin control group,and the PaO2/FiO2 value was (248.6 ± 18.9) and (280.9 ±34.8) mmHg in observation group and (220.5 ± 16.1) and (245.9 ±28.2) mmHg in control group,respectively (P ＜0.01).At 48.0 h after surgery,RVEF in observation and control groups was (0.53 ±0.05) and (0.46 ± 0.04),and PVRI was (203 ±28) and (235 ± 33) mL,respectively (P ＜0.05).Conclusion Patients after CABG that were given liposome prostaglandin can get improvement in PaO2,PaO2/FiO2,RVEF and PVRI.Liposome prostaglandin administration also contributes to the recovery of postoperative cardiopulmonary function.