摘要
目的探讨前列腺素E1(PGE1)对原位肝移植病人肺动脉高压的治疗作用,为临床用药提供理论指导。方法 2007年10月—2011年10月,选择原位肝移植病人15例,均有肺动脉高压。麻醉诱导后,从右颈内静脉放置漂浮导管,监测肺动脉压(PAP)及肺毛细血管楔压(PCWP)。经微量泵持续泵入PGE1 35μg·kg-1·min-1,分别观察无肝前期(T1)、无肝期(T2)、新肝期10min(T3)、新肝期30min(T4)、新肝期60min(T5)时PAP、PCWP、平均动脉压(MAP)及心率(HR)变化。结果 T2、T3、T4、T5与T1比较PAP明显降低,T3较T2的PAP明显升高,T4、T5与T3比较PAP明显降低,差异有统计学意义(F=32.78,P<0.05)。T2、T3、T4、T5与T1比较MAP明显降低,T3与T2比较MAP明显降低,T4、T5与T3比较MAP明显升高,差异有统计学意义(F=12.51,P<0.05)。T2、T3、T4与T1比较HR明显升高,T4、T5与T3、T2比较HR明显降低,差异有统计学意义(F=21.91,P<0.05)。结论经微量泵持续泵入PGE1 35μg·kg-1·min-1,对原位肝移植病人肺动脉高压有较好的治疗效果。
Objective To assess the therapeutic effects of prostaglandin E1 （PGE1） on pulmonary hypertension in pa- tients undergoing orthotopic liver transplantation （OLT）. Methods Fifteen patients underwent OLT （2007.10-2011.10） were selected. All of them had pulmonary hypertension. After anesthesia induction, a Swan Ganz catheter was inserted from right inter hal jugular vein, and the pulmonary artery pressure （PAP） and pulmonary capillary wedge pressure （PCWP） were measured. PGE1 was injected at 35μg·kg^-1·min^-1 by a micro-pump. The changes of PAP, PCWP, mean arterial pressure （MAP） and heart rate （HR） were measured during preanhepatic （TI）, anhepatic （T2）, neohepatic 10 rain （T3）, neohepatic 30 rain （T4） and neohepatic 60 rain （Ts）. Results The PAP in T2, T3, T4 and T5 was greatly declined as compared with that in T1, and that in T3 was greatly elevated, and that in T4 and T5 was greatly decreased as compared with Ta（F=32.78,P〈0.05）. The MAP in T2, Ta, T4 and Ts was declined as compared wl.th that in T1, and that in T3 was lower than that in T2, that in T4 and T5 was higher than that in T3（F=12.51 ,P〈0.05）. The HR in Tz, T3 and T4 was greatly increased vs. T1, T4 and T5 were greatly decreased vs. T and T3 （F=21.91 ,P〈0.05）. Conclusion PGE1 at 35/Lg · kg^-1 · min^-1 by micro pump shows a better therapeutic effect on pulmonary hypertension in patients undergoing orthotopic liver transplantation.
出处
《青岛大学医学院学报》
CAS
2013年第6期506-508,共3页
Acta Academiae Medicinae Qingdao Universitatis
基金
山东省卫生厅基金项目(2007HW049)
关键词
前列地尔
肝移植
高血压
肺性
alprostadil
liver transplantation
hypertension, pulmonary
