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目的:探讨用酚妥拉明加多巴胺治疗小儿高原性心脏病合并肺动脉高压的临床效果和应用价值。方法:将采用酚妥拉明加多巴胺微泵给药治疗的32例高原性心脏病合并肺动脉高压患儿作为治疗组,与采用综合治疗的30例高原性心脏病合并肺动脉高压患儿作对照,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:治疗组心功能和平均肺动脉压力明显有效18例,有效10例,改善2例,总有效率为93.75%,明显高于对照组(80%),两组差异有统计学意义(P<0.05)。治疗组心率(HR)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、右心房舒张期内径(RADd)、右心室舒张期内径(RVDd),平均肺动脉压(mPAP)、右心室射血分数(RVEF)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)。而治疗组治疗后肾功能指标与对照组比较差别有统计学意义(P<0.05)。结论:酚妥拉明及多巴胺治疗小儿高原性心脏病合并肺动脉高压有明显疗效,值得推广。
Objective: To investigate the clinical effect and application value of phentolamine plus dopamine in treating pulmonary heart disease complicated with pulmonary hypertension in children. Methods: Thirty-two children with heart disease complicated with pulmonary hypertension treated with phentolamine plus dopamine were used as the treatment group, compared with 30 children with pulmonary heart disease undergoing combined therapy. 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: In the treatment group, the cardiac function and mean pulmonary artery pressure were significantly effective in 18 cases, effective in 10 cases and improvement in 2 cases, the total effective rate was 93.75%, significantly higher than that in the control group (80%), the difference was statistically significant (P < 0.05). HR, PaO2, PaCO2, RADd, RVDd and mPAP in the treatment group were significantly higher than those in the control group Right ventricular ejection fraction (RVEF) and other indicators compared with the control group were significantly different (P <0.01), left ventricular systolic function index compared with the control group were statistically significant (P <0.05). The treatment group after treatment renal function indicators compared with the control group, the difference was statistically significant (P <0.05). Conclusion: Phentolamine and dopamine in children with high altitude heart disease complicated with pulmonary hypertension have obvious curative effect, which is worth promoting.