摘要
【目的】探讨多普勒超声监测不同剂量酚妥拉明对新生儿重症肺炎伴肺动脉高压疗效的意义,为临床使用酚妥拉明辅佐治疗重症肺炎、防止并发心力衰竭提供依据。【方法】连续监测22例重症肺炎患儿生命体征的变化,分别于应用酚妥拉明前及不同用药剂量时,经彩色多普勒超声测定左心室射血分数(ejection fraction,EF),左心室短轴缩短率(shortening fraction,FS),二尖瓣口血流频谱E峰、A峰值流速(maximal mitral velocity in early and late diastole,EV、AV)以及肺动脉压力(pulmonary arterial pressure,PAP)的变化。【结果】不同剂量酚妥拉明静滴时,重症肺炎患儿肺动脉压力以及射血分数改变差异有显著性,当以5 g/(kg.min)速度静滴酚妥拉明时,PAP显著下降,当进一步加大剂量至10μg/(kg.min)时,PAP进一步下降,同时体循环压力也出现明显的下降,心率加快。MVA/E比值随剂量增加呈下降趋势,但差异无显著性。且酚妥拉明剂量增加至10μg/(kg.min)时,2例患儿出现明显鼻塞。【结论】静脉应用酚妥拉明对重型肺炎伴肺动脉高压患儿有良好的血流动力学效应,相对选择性扩张肺血管,同时减轻心脏的前后负荷,宜从小剂量开始,最适剂量为5 g/(kg.min)。
[Objective] By exploring the influence of different dosage of phentolamine on pulmonary artery hypertension in newborn with severe pneumonia through color Doppler to supply the scientific basis for phentolamine used in adjuvant treatment of severe pneumonia and prevention of pneumonia complicated with heart failure. [Methods] 22 severe cases of pneumonia of newborn＇s vital sign were monitored continuously before and after different dosages of the application of phentolamine. Through color Doppler, the left ventrieular ejection fraction（ EF）, shortening fraction（ FS）, maximal rnitral velocity in early and late diastole（EV, AV）and the change of pulmonary arterial pressure（PAP） were examined. [Results] PAP and EF had significant difference when different dosages of phentolamine were applied. When at 5 μg/（kg · min）, PAP decreased significantly and when at 10 μg/（kg ·min）,PAP decreased further. But the systemic circulation pressure and heart rate commenced to change too. The ratios of MVA/E were decreased with dosage＇s augment, but variance was not significant. And snuffles was conspicuous in 2 eases. [Conclusion] Intravenous infusion of phentolamine can take the patient favourable haemodynamics effect, dilate pulmonary blood vessel with relative selectivity, and simultaneously relieve pre and postload. The dose can begin from smaller,but the ootimum dose is 5 μg/（kg·min）.
出处
《中国儿童保健杂志》
CAS
2006年第1期18-20,共3页
Chinese Journal of Child Health Care
基金
山东省卫生厅科研立项项目(2005)
