米力农治疗缩窄性心包炎术后低心排综合征疗效分析.docVIP

米力农治疗缩窄性心包炎术后低心排综合征疗效分析 　　[摘要] 目的 探讨米力农治疗缩窄性心包炎术后低心排综合征的疗效。方法 方便收集该院2012年1月―2016年6月收治的15例缩窄性心包炎并行心包剥脱术，且术后发生低心排综合征均采用常规强心、升血压、呼吸机辅助呼吸等处理后患者心率、血压未见好转，加用米力农负荷量为50 μg/kg，维持剂量为0.5 μg/（kg?min）速度以输液泵静脉注射，全天总量不超过1.1 mg/kg，疗程2～5 d，分析患者加用米力农治疗前后的血压、心率、停呼吸机等临床指标。结果 米力农的临床有效率为87%，对低心排综合征有明显疗效，且未见明显不良反应发生。结论 米力农治疗缩窄性心包炎术后低心排综合征安全、有效。 　　[关键词] 缩窄性心包炎；米力农；低心排综合征 　　[中图分类号] R542.11 [文献标识码] A [文章编号] 1674-0742（2017）02（a）-0117-03 　　[Abstract] Objective To observe the curative effect of milrinone in treatment of low cardiac output syndrome after the constrictive pericarditis operation. Methods Convenient selection 15 cases of patients with constrictive pericarditis and pericardiectomy admitted and treated in our hospital from January 2012 to June 2016 were selected and the heart rate and blood pressure of patients were not improved after adopting the routine Cardiac， hypertensive and breathing machine ventilatory support， and the milrinone load capacity was 50 μg/kg， and the speed of infusion pump intravenous injection was 0.5 μg/（kg?min）， and the all-day total amount was not more than 1.13 mg/kg， and the treatment course was from 2 to 5 days， and the blood pressure， heart rate and breathing machine stopping and other clinical indexes before and after treatment were analyzed. Results The clinical effective rate of milrinone was 87%， and the curative effect of milrinone for low cardiac output syndrome is obvious， and there were no obvious adverse reactions. Conclusion Milrinone in treatment of low cardiac output syndrome after the constrictive pericarditis operation is safe and effective. 　　[Key words] Constrictive pericarditis； Milrinone； Low cardiac output syndrome 　　慢性?s窄性心包炎由各种病因引起心包的脏，壁层慢性炎症、纤维素性渗出并纤维化，并逐渐机化、增厚、挛缩、钙化，压迫心脏及大血管根部，而导致心脏舒张期充盈受限，从而引起右心房、腔静脉压增高及心排出量降低等循环功能障碍[1]。慢性缩窄性心包炎确诊后应积极行心包的剥脱、切除，这是解除心脏机械性压迫的唯一有效的治疗方法[2]。而缩窄性心包炎术后发生低心排综合征概率较高，低心排综合征是心肌损害引起心脏泵功能下降，循环容量、阻力均正常或有较大代偿的情况下，心泵血功能仍然不能满足机体循环的需求，而出现循环衰竭，机体组织出现低灌注，是临床常见的急危重症[3]，并为手术早期死亡的重要原因，其治疗是心胸外科工作中的一项难题。为了探讨米力农治疗缩窄性