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目的:探讨米力农微泵给药在婴幼儿高原性心脏病合并肺动脉高压治疗中的临床效果和安全性。方法:将65例高原性心脏病合并肺动脉高压的患儿随机分为治疗组和对照组。治疗组34例给予米力农0.5μg/(kg.min);对照组31例给与多巴胺5μg/(kg.min),两组均持续微泵给药,连续应用7天。通过观察临床症状和体征及应用彩色多普勒超声诊断仪测量心脏结构、估测平均肺动脉压和心功能指标来判断疗效。结果:米力农的临床总有效率为91.2%,多巴胺组临床总有效率为71.0%,两组治疗后临床疗效有统计学意义(P<0.05);米力农组右心室射血分数(RVEF)、平均肺动脉压(mPAP)等指标与对照组比较差异均有显著性(P<0.01),左心室收缩功能指标与对照组比较有统计学差别(P<0.05)。结论:米力农治疗婴幼儿高原性心脏病合并肺动脉高压可明显改善心功能,未见不良反应,安全有效。
Objective: To investigate the clinical effect and safety of milrinone micropump in the treatment of patients with high altitude heart disease and pulmonary hypertension. Methods: 65 cases of heart disease with pulmonary hypertension in children were randomly divided into treatment group and control group. In the treatment group, 34 cases were given Milrinone 0.5μg / (kg · min); in the control group, 31 cases were given dopamine 5μg / (kg · min). Both groups continued to use micropumps for 7 consecutive days. By observing the clinical symptoms and signs and application of color Doppler ultrasound diagnostic cardiac structure, estimating the average pulmonary arterial pressure and cardiac function indicators to determine the efficacy. Results: The total clinical effective rate was 91.2% in Milrinone group and 71.0% in the dopamine group, and the clinical effect was statistically significant after treatment (P <0.05). The right ventricular ejection fraction RVEF and mPAP were significantly different from those in the control group (P <0.01). Left ventricular systolic function was significantly different from that in the control group (P <0.05). Conclusion: Milrinone treatment of heart disease in infants with high altitude heart disease complicated with pulmonary hypertension can significantly improve cardiac function, no adverse reactions, safe and effective.