西地那非治疗婴幼儿先天性心脏病术后肺动脉高压

[目的]观察西地那非对婴幼儿先天性心脏病(简称先心病)手术后严重肺动脉高压的疗效.[方法]总结本院2009年1月至2010年6月应用西地那非治疗婴幼儿室间隔缺损合并重度肺动脉高压共33例.本组术毕停体外循环后置管测定肺动脉压力仍超过体动脉压力(桡动脉置管测定外周动脉压)50%以上,术后1d给予鼻饲西地那非,初始剂量0....

Sildenafil for the Treatment of Pulmonary Hypertension after Surgery of Congenital Heart Disease in Infants

[Objective]To observe the efficacy of sildenafil for the treatment of pulmonary hypertension after surgery of congenital heart disease in infants. [Methods]Thirty three infants with ventrieular septal defect complicated with severe pulmonary hypertension treated by sildenafil in our hospital from Jan. 2009 to Jun. 2010 were summarized. After surgery and the stopping of cardiopulmonary bypass, pulmonary artery pressure measured by intubation was more than 50% of systematic artery pressure（peripheral arterial pressure measured by radial artery intubation）. Sildenafil was administrated via nasal feeding at 1 day after surgery, and the initial dose was 0.5mg/kg. The dose of sidenafil was increased by 0.5mg/kg every 6 hours until a maximum close of 2 mg/kg. The changes of pulmonary artery pressure（PAP）, systematic artery pressure（SAP）, arterial partial pressure of oxygen（PaO2）, arterial partial pressure of carbon dioxide（PaCO2 ） and inhaled oxygen fraction during ventilation were observed. All patients were reexamined by eehocardiography before discharged from the hospital and a month after discharged from the hospital. PAP was measured by using tricuspid regurgitation method. [Results]At an hour after taking the maximum dose（2 mg/kg） of sildenafil, PaO2 increased and PAP decreased, while SAP had no obvious change in all patients. No one had pulmonary hypertensive crisis. No pulmonary artery pressure rebounding after the stopping of inhalation of nitric oxide（NO） occurred. At a month after discharged from the hospital, PAP was normal in all infants. [Conclusion] Sildenafil for the treatment of severe pulmonary hypertension after congenital heart surgery in infants is effective;