吸入一氧化氮治疗二尖瓣狭窄术后肺动脉高压的研究

目的 观察吸入ＮＯ治疗二尖瓣狭窄（ＭＳ）术后肺动脉高压（ＰＨ）的疗效。方法 ３０例ＭＳ二尖瓣置换（ＭＶＲ）术后ＰＨ病人，吸入２０ｐｐｍＮＯ３０ｍｉｎ后，停吸ＮＯ，１５ｍｉｎ后再吸入６ｐｐｍＮＯ，直至脱离呼吸机。采用Ｓｗａｎ－Ｇａｎｚ导管技术监测吸入前后的血液动力学及氧合指标。结果 吸入２０ｐｐｍＮＯ５ｍｉｎ后，肺动脉压、肺循环阻力、肺泡动脉血氧分压差及肺内分流率明显降低、中心静脉压、心率、心排血量

Therapeutic effects of inhaled nitric oxide in patients with pulmonary hypertension after mitrai valve replacement

Objective To assess therapeutic effects of inhaled nitric oxide in patients with pulmonary hypertension (PH) after mitral valve replacement(MVR) Methods Thirty patients with PH (mPAP>2 67kPa) after MVR were enrolled in the study Parameters in hemodynamics and oxygenation were measured with Swan Ganz technique , 5min before NO inhalation (T 1), 5,15 and 30min following NO 20ppm inhalation (T 2,T 3,T 4), 15min after stopping NO 20ppm inhalation (T 5), 15min and 5h following NO 6ppm inhalation (T 6,T 7) and 15min before and after weaning from mechanical ventilator (T 8,T 9) respectively Results Compared with those at T 1, at T 2 pulmonary artery pressure, pulmonary vascular resistance, alveolar arterial oxygen difference and intrapulmonary shunting significantly decreased, but arterial oxygen partial pressure, oxygen content and oxygen availability index increased significantly (P<0 05 or 0 01) At T 5, all parameters above returned to the levels at T 1 At T 6 all parameters above returned to the levels at T 2 and were kept at these levels from T 7 to T 9 The pulmonary capillary wedge pressure, central venous pressure, heart rate, cardiac output, cardiac index and systemic vascular resistance remained unchanged markedly during whole procedures (P>0 05) Conclusions The persistently inhaled low dose NO is effective and safe for the pulmonary hypertension induced with heart surgery