二尖瓣置换术围手术期硝普钠的应用

本文介绍了20例二尖瓣置换术病人围手术期使用硝普钠的经验。术中和术后早期使用硝普钠可降低肾素-血管紧张素系统的活性、减轻外周血管阻力和后负荷,增强泵血功能,从而使心脏指数升高,降低术后高血压和肺水种的发生率。体外循环停止后,硝普钠与低浓度升压药并用可增强心肌收缩力,预防低排综合征

USE OF SODIUM NITROPRUSSIDE DURING PERIOPERATIVE PERIOD OF MITRAL VALVE REPLACEMENT

The effect of perioperative use of Sodium nitroprusside (SNP) was reviewed in 20 patients undergoing mitral valve replacement. 0.01% SNP was used for intravenous infusion with an average dose of 1.15 + 0.57 ug/kg/min. Intravenous GIK was used also preoperatively to improve myocardial energy reserve and cardiac function. SNP helps to improve cardiac output by reducing renin-angiotensin activity and lowering both the systemic arterial and the pulmonary arterial pressure so as to lessen the preload as well as the afterload of the heart. Low dose dopamine was used in company with SNP after bypass if necessary. It helps to improve myocardial contractility, and to prevent low-cardiac output syndrome. Blood volume should be adequately supplemented before SNP infusion. Hemodynamic changes should be watched carefully during infusion of SNP, and potassium administered according to the urinary output. Effect of perioperative use of SNP was found satisfactory in mitral valve replacement