先天性心脏病合并肺动脉高压婴儿围手术期应用波生坦的疗效观察

目的观察波生坦在围手术期治疗先天性心脏病婴儿合并中、重度肺动脉高压中的效果。方法将60例1月～1岁先天性心脏病合并肺动脉高压的婴儿,随机分为两组。A组30例接受常规治疗,B组30例在常规治疗基础上加用波生坦口服治疗,术前6.25 mg,2/d,应用7天;术后12.5 mg,2/d,应用1～4周。记录两组用药前、用药后1周和术后治疗1周时的肺动脉收缩压,比较两组术后机械辅助通气时间,评价波生坦的疗效。结果 B组肺动脉收缩压较A组持续下降（P=0.002）;术后机械辅助通气时间较A组显著缩短。结论波生坦在婴儿先天性心脏病合并中、重度肺动脉高压围术期中的应用安全有效。

Perioperative Therapeutic Effects of Bosentan on Infants with Congenital Heart Diseases with Pulmonary Artery Hypertension

Objective To investigate the perioperative treatment effects of Bosentan on infants with congenital heart diseases(CHD) with pulmonary artery hypertension(PAH).Methods A total of 60 infant patients suffered from CHD with moderate to severe PAH were randomly divided into 2 groups.Group A(control group) underwent conventional treatment.Group B underwent oral administration of Bosentan(preoperation,6.25 mg,2/day,lasting for 1 week;postoperation,12.5 mg,2/day,lasting for 1-4 week) besides conventional treatment.The both groups received dopamine treatment to improve the heart function.The pulmonary artery pressure before drug administration,1 week after drug administration and 1 week after surgery was recorded.The mechanical ventilation times after surgery were compared between two groups and the therapeutic effect of Bosentan was evaluated.Results Pulmonary artery systolic pressure in group B was significantly reduced(P=0.002),and the mechanical ventilation time was significantly shorter(P=0.001) than that in group A.Conclusion Bosentan is safe and effective when applied to CHD infants with moderate to severe PAH.