前列地尔对原位肝移植患者血流动力学的影响研究

发布时间：2018-03-23 00:29

本文选题：肝移植　切入点：血流动力学　出处：《重庆医学》2016年35期 　论文类型：期刊论文

【摘要】：目的观察原位肝移植手术新肝期静脉泵注前列地尔(PGE1)对血流动力学的影响,为临床合理用药提供参考。方法选取2011~2015年在该院移植中心接受原位肝移植的患者30例,采用计算机随机数字表法将其分为对照组、E1组和E2组,各10例;在原位肝移植手术新肝期,E1组与E2组患者分别以5、10ng/(kg·min)静脉泵注PGE1,对照组泵注等量生理盐水,其余处理相同;在新肝期30min分别纪录心率(HR)、平均动脉压(MAP)、肺动脉压(PAP)、心排血量(CO)、外周血管阻力(SVR)。结果 3组患者年龄、体质量、手术时间、无肝期时间、失血量及输注量比较,差异均无统计学意义(P0.05)。在门静脉、肝上下腔静脉开放后30min,与对照组比较,E1组及E2组HR、CO均增加,MAP下降,但差异均无统计学意义(P0.05);E1组及E2组SVR和PAP均下降,且随PGE1使用剂量增加而下降,E1组及E2组患者PAP与对照组比较,差异均有统计学意义(P0.05),仅E2组SVR与对照组比较,差异有统计学意义(P0.05)。结论在处理肝移植新肝期PAP增高和CO降低时,静脉泵注PGE1可作为有效的处理办法。
[Abstract]:Objective to observe the effect of intravenous infusion of alprostadil PGE1 on hemodynamics in orthotopic liver transplantation (OLT) in order to provide a reference for rational use of drugs in clinic. Methods Thirty patients received orthotopic liver transplantation (OLT) in our hospital from 2011 to 2015 were selected. They were randomly divided into control group (E _ 1) and E _ 2 group (n = 10). PGE1 was injected intravenously in group E _ 1 (n = 10) and group E _ 2 (n = 10) in the new liver phase of orthotopic liver transplantation, and the control group was treated with the same amount of normal saline. Heart rate, mean arterial pressure, pulmonary artery pressure, cardiac output and peripheral vascular resistance were recorded in the three groups by 30min. Results Age, body mass, operation time, time of anhepatic phase, blood loss and transfusion volume were compared among the three groups. In portal vein and inferior hepatic vena cava 30 min after opening, compared with the control group, HRCO in E 1 group and E 2 group increased and map decreased, but there was no significant difference between P 0.05 and E 2 groups in SVR and PAP. With the increase of the dosage of PGE1, the PAP of E1 group and E2 group were significantly lower than that of the control group (P 0.05), but the SVR of E 2 group was significantly higher than that of the control group (P 0.05). Conclusion in the treatment of liver transplantation, the increase of PAP and the decrease of CO in liver transplantation are significant. Intravenous injection of PGE1 can be used as an effective treatment.
【作者单位】：四川省医学科学院/四川省人民医院麻醉科;
【基金】：四川省卫生厅科研基金资助项目(140085)
【分类号】：R614

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