| ObjectivePH is one of common and severe complications in CHD. In a few of common CHD, the case of MPAP >40mmHg is about 5 -25% , it is difficult to treat among the severe PH cases. Although operation is very satisfy, because of the changes of pneumoangiogram pathology and physiology, surgical trauma, extracorporeal circulation, the changes of blood volume postoperation, acid - base balance, iondisorder and emotion, It is common that pulmonary pressure increase continually, cardiac output decrease and happen pulmonary hypertensive crisis. It become the mainly death cause in early postoperation. It is the topic of cardiac surgery how to decrease pulmonary pressure, protect cardiac function.Application of expanding vascellum drugs is the main method in treating PH. Since 1957, PGE, is separated by Bergston, it is proved that decreasing pulmonary pressure and improving cardiac function is obviously advantage of NP and NO. PGE1 is considered the ideal drugs of expanding pneumoangiogram, especially in treatment of pulmonary hypertension for CHD,But in different records, the optical dose is very different, from 3 ng/kg . min to 200 ng/kg · min. Some one think that low - midst dose have apparent effection in decreasing pulmonary pressure, but others consider that large dose ( 100 - 200 ng/kg . min) have significant therapeutic effect, no adverse reaction. Because PGE1 have many side effect. Such as decreasing MAP, PaO2, SaO2 and unexpected death in treating severe pulmonary vascular bed process, in clinic usually adopt low - midst dose. With the developing of surgical tech-nic, extracorporeal circulation level, monitor level, previous treatment level canX need contemporary medical treatment . So it is necessary to solve security and the dose - effect relation - ship, it is necessary to explore the dose - effect relationship of PGE1 in treatment of different degree pulmonary hypertension on the postoperation patients of congenital heart defect. In order to determin optimal dose.MethodsForty - four patients associated with pulmonary hypertension caused by congenital heart disease were selected, men 28 examples, women 16 examples. Age 2. 7 - 10 years. Cardio - thoracic ration 0. 56 - 0. 75, average 0. 65. heart colour ultrasound display different degree PH, X - R stemite display pulmonary congestion. A part of patients are diagnosed PH by right heat catheterization. Swan - Ganz float catheter was put into pulmonary artery through right jugular vein just after anaesthesia. The indexes of MPAP and hemodynamics were measured preoperation. According to MPAP , the patients are divided into two groups, slight -moderate group and severe group. After cardiac surgery, comes back ICU. After circulation system stabilization, using PGE, at the doses of 20. 40. 60. 80. 120. 160 ng/kg . min respectively to study dose -effect relationship.Result(1) In slight - moderate group, after operation, MPAP decrease obviously, when using PGEt at the dose of 20 ng/kg . min, MPAP begin to decline, at the dose of 60 ng/kg . min, MPAP at the peak of declining ( P <0.01). the other indexes are in the range of normal. In the moment, CI increased significantly(P <0.01). there were obviously dose -effect relationship between different doses. No adverse reactions emerge in different doses. When the dose is larger than 60 ng/kg . min, side reactions occur.(2 ) In severe group, there were no significant change of postoperation MPAP, at the dose of 20 ng/kg . min, although there were no changes of...
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