呼气末正压对先天性心脏病肺动脉高压患者术后肺功能的作用

目的探讨呼气末正压(PEEP)对先天性心脏病合并肺动脉高压患者术后肺呼吸功能的作用。方法把46例室间隔缺损合并中、重度肺动脉高压患者随机分为治疗组和对照组,两组患者均行心脏直视手术,治疗组术后行PEEP。分别比较两组手术时间、体外循环时间、主动脉阻断时间以及术后1、6、12、24、48h的平均肺动脉压、肺血管阻力、肺泡-动脉氧张力差、呼吸指数。结果两组患者手术时间、体外循环时间、主动脉阻断时间、平均肺动脉压间差别无显著性意义(P>0·05);治疗组肺血管阻力、肺泡-动脉氧张力差及呼吸指数明显低于对照组(P<0·05)。结论肺动脉高压患者心脏直视术后采用PEEP通气模式,能够改善术后肺的呼吸功能。

Effects of PEEP on Respiratory Function after Cardiac Surgery in Congenital Heart Diseases with Pulmonary Hypertension Patients

Objective To investigate the effects of Positive-pressure respiration (PEEP) on respiratory function after cardiac surgery in pulmonary hypertension patients with congenital heart diseases.Methods 46 ventricular sepal defect with pulmonary hypertension patients were divided into therapy group (n=23) and control group (n=23) randomly,and PEEP were used in the therapy group.The time of operation,cardiopulmonary bypass,aorta clamp were compared in two groups.Mean pulmonary artery pressure,pulmonary vascular resistance,alveolar-arterial oxygen tension difference and respiratory index were measured at several points for 1,6,12,24,48 h after operation in all patients.Results There were no significance in the time of operation,cardiopulmonary bypass and aorta clamp,and mean pulmonary artery pressure (P>0.05).Pulmonary vascular resistance,alveolar-arterial oxygen tension difference and respiratory index in therapy group were lower than those in the control group significantly (P<0.05).Conclusion The usage of PEEP after cardiac surgery in pulmonary hypertension patients with congenital heart diseases may improve the respiratory function.