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肺動脈高壓的治療

Review of Pulmonary Arterial Hypertension Management

摘要


肺動脈高壓的初期表徵不明顯,因此常常在臨床上被忽略,但是嚴重肺動脈高壓的患者往往引發致命性且不可逆的心肺衰竭。我們可以藉由經胸廓心臟超音波的估算或肺動脈導管的放置來測量肺動脈壓,並及時投以藥物治療以減緩肺心症的發生。目前在治療肺動脈高壓的藥物研究,已有血管升壓劑與強心劑、肺動脈擴張劑、利尿劑、毛地黃、鈣離子通道阻斷劑的相關研究,其中又以肺動脈擴張劑的發展最爲蓬勃。外科治療的角色因其適應症的受限,目前應用範圍不大。本文簡要回顧目前肺動脈高壓的治療方式,以爲臨床醫師用藥之參考。

並列摘要


The early presentation of pulmonary arterial hypertension is insidious, so it is easy to be missed in our practice. As the high pulmonary arterial pressure persists, it complicates cardiopulmonary resuscitation. We can measure the pulmonary vascular pressure by transthoracic echocardiography or by pulmonary arterial catheter monitoring. Some medications, such as vasopressors, inotropes, pulmonary vasodilators, and diuretics, are shown to slow the progression of cor pulmonale. We reviewed the literatures of pulmonary arterial hypertension management and provide a drug reference for clinicians.

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