室间隔缺损合并中重度肺动脉高压围术期治疗  

Treatment During the Period of Operation Including Its Pre and Postterm for Ventricular Septal Defect Complicated by Moderate and Severe Pulmonary Hypertension

作　　者：王鹰 韩玲[1,2] 王惠玲 曹嘉湘[1,2] 金梅 吴桂萍[1,2] 

机构地区：[1]广西桂林市人民医院 [2]北京市安贞医院

出　　处：《华夏医学》1997年第6期5-7,共3页Acta Medicinae Sinica

摘　　要：为进一步探讨室间隔缺损合并中重度肺动脉高压围术期治疗，作者收集１９９７年１月至１９９７年６月期间，手术治疗室间隔缺损合并中重度肺动脉高压２６例临床资料，其中重度肺动脉高压８例，中度肺动脉高压１８例。占同期先天性心脏病手术患儿总数的１４％（２６／１８５）。男１３例，女１３例，年龄２月至１５岁（４．０±４．２岁），体重５．５～３７ｋｇ（１４．０±８．８ｋｇ）。术前ＳｐＰＡ６．７～１６ｋＰａ，Ｐｐ／Ｐｓ０．６～１．０，肺动脉血氧饱和度均大于０．９。２例＜１岁患儿和２例＜２岁重度动脉高压患儿未行右心导管及附加试验。２～１４岁重度肺动脉高压患儿４例术前给予右心导管吸氧或妥拉苏林附加试验结果，肺血管总阻力下降（９７０±４１２．８）达因·秒·厘米－５。全组患儿在中低温体外循环下行室间隔缺损修补术，术后肺动脉压力下降，无一例死亡。For further discussing on the treatment during the period of operation including pre and postterm for ventricular septal defect complicated by moderate and severe pulmonary hypertension,the authors collected 26 cases of clinical data of operational treatment from January 1997 to June 1997,among them severe cases were 8 and moderate cases were 18,accounting for 14%(26/185) of the sum total of the patients with congenital heart disease received operational treatment.The male patients were 13,female,13;age:2m～15y(4.0±4.2y);body weight:5.5～37kg(14.0±8.8kg).Before operation,SpPA6.7～16kPa,Pp/Ps 0.6～1.0,the degree of blood oxygen saturation of pulmonary artery>0.9.No right cardic catheration and additional test were conducted for 2 cases of<1y and 2 cases<2y with severe pulmonary hypertension.Another 4 cases of 2～14y with severe pulmonary hypertension received left cardiac catherization and oxygen inhalation of additional test of tolazoline before operation,the results showed that the total resistence of pulmonary vessels reduced 970±412.8 Dyne/S/cm-5.The operation for repairing ventricular septal defect in this group was conducted under extracorporal circulation with moderate lower temperature.After the operation the pulmonary hypertension reduced without any death in all the cases.The clinical practice achieved satisfactery results.

关 键 词：室间隔缺损 肺动脉高压 围术期治疗 

分 类 号：R541.1[医药卫生—心血管疾病]