临床小儿外科杂志2025，Vol.24Issue(3)：255-259,5.DOI:10.3760/cma.j.cn101785-202304038-010
罂粟碱联合利多卡因在先天性心脏病心导管介入手术致肢体急性缺血中的应用研究
Study on the application of papaverine combined with lidocaine in acute limb ischemia caused by cardi-ac catheterization intervention in infants with congenital heart disease
摘要
Abstract
Objective To evaluate the clinical effect of local injection of papaverine combined with lido-caine in treating acute limb ischemia caused by vascular spasm after cardiac catheterization in infants with con-genital heart disease(CHD).Methods A retrospective analysis was conducted on clinical data from infants who developed acute limb ischemia due to vascular spasm after CHD cardiac catheterization at the Heart Center of Women and Children's Hospital Affiliated to Qingdao University between June 2008 to June 2023.This study included 4 male and 2 female infants,with 4 cases of patent ductus arteriosus and 2 cases of severe pulmonary valve stenosis.A local injection treatment was performed with a solution of papaverine 1.5 mg/kg combined with 2％lidocaine 1 mL,totaling 3 mL,at the puncture site on both the inner and outer sides of the affected limb.Observations were made on the skin color,temperature,dorsalis pedis artery pulsation,and transcutaneous oxygen saturation(SpO2)of the affected limb.Comparisons were made between the pre-and post-injection skin color grade,limb circumference,skin temperature,and SpO2.The time for ischemic symptoms to alleviate was recorded.Liver function indicators(alanine aminotransferase,aspartate aminotransferase,and serum prealbu-min)were measured before and 72 h after the papaverine injection.Results 6 infants received local papaver-ine injection treatment.The pre-injection levels were:alanine aminotransferase 18.81±7.07 U/L,aspartate amin-otransferase 37.83±9.56 U/L,serum prealbumin 13.44±1.59 mg/L,limb circumference 19.75±2.48 cm,skin temperature 34.95±0.18℃,and SpO2 88.83±1.72％.Post-injection levels were:alanine aminotransferase 17.13±6.57 U/L,aspartate aminotransferase 40.71±15.16 U/L,serum prealbumin 13.61±1.66 mg/L,limb circumference 20.08±2.43 cm,skin temperature 36.33±0.25℃,and SpO2 94.17±1.18％.Significant statistical differences were found in the skin temperature and SpO2 of the affected limb before and after papaver-ine injection(P＜0.05).No statistically significant differences were found in limb circumference,alanine ami-notransferase,aspartate aminotransferase,and serum prealbumin levels before and after injection(P＞0.05).The average recovery time for ischemic symptoms was 0.5 to 2.0 hours,with a mean of 1.17±0.53 hours.Conclusions Local injection of papaverine combined with lidocaine effectively alleviates arterial vasospasm without causing serious complications.关键词
罂粟碱/心导管介入/血管痉挛/外科手术/儿童Key words
Papaverine/Cardiac Catheterization/Vasospasm/Surgical Procedures,Operative/Child引用本文复制引用
王葵亮,张旭,罗刚,泮思林..罂粟碱联合利多卡因在先天性心脏病心导管介入手术致肢体急性缺血中的应用研究[J].临床小儿外科杂志,2025,24(3):255-259,5.基金项目
国家自然科学基金(82271725) （82271725）
泰山学者工程资助(2018) National Natural Science Foundation of China(82271725) （2018）
Taishan Scholars Program Funding(2018) （2018）
