吸入一氧化氮对室间隔缺损手术后肺动脉高压的疗效观察

目的　观察吸入一氧化氮(nitricoxide,NO)治疗室间隔缺损 (ventricularseptaldefect,VSD)术后肺动脉高压 (pulmonaryhypertension ,PH)的疗效。 方法　 2 0例VSD术后PH病人分别吸入 2 0×10 -6 、6× 10 -6 NO ,监测吸入前后的血流动力学、氧合指标。结果　吸入 2 0× 10 -6 NO后明显降低肺动脉压、肺循环阻力、肺内分流率、肺泡动脉血氧分压差 ,提高动脉血氧分压、氧供指数 ;以上指标停吸NO后恢复吸入NO前水平 ;再吸入 6× 10 -6 NO后恢复吸入 2 0× 10 -6 NO后水平 ,并维持至停吸NO后。吸入前后体循环压及阻力无变化。结论　吸入NO是治疗VSD手术后PH的一种有效的方法。

The effect of inhaled nitric oxide therapy on the postoperative patients of ventricular septal defect with pulmonary hypertension

Objective To assess the effect of inhaled nitric oxide (NO) therapy on the postoperative patients of ventricular septal defect (VSD) with pulmonary hypertension (PH). Methods Twenty postoperative patients of VSD with PH (mPAP>2.67 kPa) inhaled 20 ppm and 6 ppm NO. Parameters including hemodynamics, oxygen index, etc. in the inhaled NO were analyzed. Results Inhaled 20 ppm NO significantly decreased pulmonary artery pressure (PAP), pulmonary vessel resistance (PVR), pulmonary venous admixture (Qs/Qt) and alveolar arterial oxygen different (AaDO 2), rose arterial oxygen partial pressure (PaO-2) and oxygen availability index (O-2AVI). After stopping NO 20 ppm inhalation, all parameters above returned to the level before NO inhalation. After NO 6 ppm inhalation again, all parameters above returned to the level after NO 20 ppm inhalation and kept this level after NO 6 ppm inhalation stopped. During the period of observation, systemic artery pressure (BP), systemic vascular resistance (SVR) remained unchanged ( P >0.05). Conclusion Inhaled NO therapy is an effective method to the postoperative patients of VSD with PH.