先天性心脏病合并重度肺动脉高压的外科治疗体会  

Surgical management of congenital heart disease with severe pulmonary hypertension

作　　者：李红卫[1] 杨丽华[1] 周晴[1] 法宪恩[1] 

机构地区：[1]郑州大学第二附属医院心血管外科,郑州450003

出　　处：《医学信息（手术学分册）》2007年第11期981-983,共3页Medical Information Operations Sciences Fascicule

摘　　要：目的总结先天性心脏病合并重度肺动脉高压的外科治疗及有关围手术期的处理经验。方法1998年12月～2006年12月手术治疗先心病合并重度肺动脉高压共121例，男56例，女65例，年龄2～54岁，平均（18．0±9．5）岁。术前肺动脉和体动脉收缩压比Pp／Ps均〉0．75，平均（0．95±0．16），动脉血氧饱和度SaO2 75％～96％。结果手术死亡10例（8．26％）。主要并发症：低心排血量2例，肺高压危象8例。死亡原因：低心排血量，肺高压危象。术后SaO2 90％～97％，平均（94±2．1）％。患者心功能均较术前改善。结论低心排血量和肺高压危像是合并重度肺高压的先心病患者术后的主要并发症和死亡原因，围术期处理是提高生存率的关键．Objective To summarize the experience of surgical management of congenital heart disease in patients with severe pulmonary. Methods From December 1998 to December 2006, 121 patients with congenita/heart disease and severe pulmonary hypertension underwent open heart surgery. There were 56 males and 65 females. The age ranges from 2 to 54 years. The ratio of pulmonary systolic pressure to systemic systolic pressure was higher than 0.75 （ mean 0. 95±0.16） and arterial oxygen saturation ranged from 75% to 96% before surgery. Results There were 10 operative deaths giving the hospital mortality of 8.26%. The major postoperative complications included low cardiac output and pulmonary hypertension crisis. Postoperative arterial oxygen saturation ranged from 90% to 97% （mean 94% ± 2. 1% ）, The heart function of the survivals was better than that before operation. Conclusions Low cardiac output and pulmonary hypertension crisis are two major postoperative complications and dead course. Preoperative treatment is the vital point to improve the survival ratio.

关 键 词：先天性心脏病 重度肺动脉高压 外科治疗 

分 类 号：R541.1[医药卫生—心血管疾病]