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本文总结了19例心脏瓣膜病病人,心脏直视手术后出现低心排血量综合征(低心排),以致不能脱离体外循环。除调整正常心率、心律、应用多巴胺15μg·kg~(-1)/min、肾上腺素20ng·kg~(-1)/min增强心肌收缩,维持心泵适当前负荷外,还需合并扩血管药物治疗。酚妥拉明扩张体循环小动脉,其可降低后负荷而使前负荷维持在一个较高的适当水平。本支强调了在与正性肌力药物合并作用下,酚妥拉明对那些左室已处于功能曲线顶点而前负荷并不充分的低心排早期,能起到迅速逆转恶性循环发展的作用,起到扬长抑短作用,提高了治疗成功率。
This article summarizes 19 patients with valvular heart disease, cardiac surgery, low cardiac output after cardiac syndrome (low cardiac output), so that they can not break away from the cardiopulmonary bypass. In addition to adjusting the normal heart rate and heart rate, dopamine (15 μg · kg -1 / min) and epinephrine (20 ng · kg -1) / min were used to enhance myocardial contractility and to maintain proper cardiopulmonary bypass. treatment. Phentolamine expands the systemic arterioles, which reduce the postload and maintain the preload to a higher appropriate level. This note emphasizes that in combination with inotropes, phentolamine may have a rapid reversal of the development of the vicious circle of low cardiac output early in those patients whose left ventricle is at the apex of the functional curve with insufficient preload. , Play a shorter role in shortening, improve the success rate of treatment.