摘要
目的评价雾化吸入米力农对慢性阻塞性肺疾病(COPD)合并肺动脉高压(PH)患者手术中心功能和肺动脉压改善的临床效果。方法选择2015年6月至2016年6月重庆市急救中心确诊为COPD合并PH的手术患者44例,其中胸部手术23例,腹部手术13例,下肢骨折手术8例。患者分为对照组与治疗组,各22例。对照组接受常规综合治疗;治疗组除接受常规综合治疗外,在全身麻醉前雾化吸入米力农。两组均右颈内静脉置入漂浮导管检测临床指标:心输出量(CO)、肺动脉收缩压(PASP)、肺动脉平均压(PAMP)、肺动脉毛细血管楔坎压(PCWP)。结果治疗组治疗后较治疗前CO明显增高(P<0.05);PASP、PAMP、PCW明显降低(P<0.05)。对照组治疗前后CO、PASP、PAMP、PCWP无明显改善,比较差异无统计学意义(P>0.05)。结论 COPD合并PH患者在手术前雾化吸入米力农,可以有效改善患者的心肺功能。
Objective To evaluate the clinical effect of milrinone nebulized inhalation for improving intraoperative cardiac function and pulmonary arterial pressure in the patients with chronic obstructive pulmonary disease(COPD)complicating pulmonary hypertension(PH).Methods Forty-four surgical patients with COPD complicating PH in the Chongqing Municipal Medical Emergency Center from June 2015 to June 2016 were chosen,including 23 cases of thoracic surgery,13 cases of abdominal surgery and 8 cases of lower extremity fracture surgery.The patients were divided into the control group and treatment group,22 cases in each group.The control group received the routine comprehensive treatment.In addition receiving the conventional comprehensive treatment,milrinone nebulized inhalation in the treatment group was given before general anesthesia.Both of the two groups were imbedded with floating catheter in the right internal jugular vein for detecting the clinical indexes:cardiac output(CO),pulmonary artery systolic pressure(PASP),pulmonary artery mean pressure(PAMP)and pulmonary capillary wedge pressure(PCWP).Results Compared with before treatment,CO after treatment in the treatment group was significantly increased(P<0.05),PASP,PAMP and PCWP after treatment in the treatment group were significantly decreased(P<0.05).CO,PASP,PAMP and PCWP in the control group had no statistical difference between before and after treatment,the difference was not statistically significant(P>0.05).Conclusion Intraoperative milrinone nebulized inhalation in the patients with COPD complicating PH can effectively improve the patient′s cardiopulmonary function.
作者
赵卫兵
陈菲
彭方毅
姜海蓉
彭方亮
ZHAO Weibing;CHEN Fei;PENG Fangyi;JIANG Hairong;PENG Fangliang(Department of Anesthesiology,Chongqing Municipal Public Health Treatment Center,Chongqing 400030,China;Department of Anesthesiology,Chongqing Municipal Medical Emergency Center,Chongqing 400014,China;Department of Clinical Laboratory,Dianjiang County Hospital of Traditional Chinese Medicine,Chongqing 408300,China;Department of Clinical Laboratory,Chongqing Municipal Public Health Treatment Center,Chongqing 400030,China;Department of Gynecology and Obstetrics,Chongqing Municipal Medical Emergency Center,Chongqing 400014,China)
出处
《重庆医学》
CAS
2018年第10期1351-1353,共3页
Chongqing medicine
基金
重庆市卫生和计划生育委员会基金资助项目(2015ZBXM088)
关键词
米力农
高血压
肺性
雾化吸入
肺动脉高压
全身麻醉
milrinone
hypertension,pulmonary
nebulized inhalation
pulmonary hypertension
general anesthesia
