室间隔缺损并重度肺动脉高压的外科治疗  

SURGICAL MANAGEMENT OF VENTRICULAR SEPTAL DEFECT ASSOCIATED WITH SEVERE PULMONARY HYPERTENSION

作　　者：张庆广 陈茂华 郑庆林 王玉玖 

出　　处：《滨州医学院学报》2000年第6期531-532,共2页Journal of Binzhou Medical University

摘　　要：目的 :评估围手术期处理对手术治疗室间隔缺损并严重肺动脉高压的影响。方法 :结合临床检查胸透、ECG、UCG、血气分析对 2 8例室间隔缺损并重度肺高压患者进行评价。肺动脉压 70～ 1 1 5/35～ 63mm Hg,Pp/Ps为 0 .89± 0 .1 4,术前给予吸氧、口服 ACEI,静脉给予酚妥拉明、极化液以及强心利尿等综合治疗 2～ 3周 ,体外循环下直视修补缺损及合并畸形 ,术后对病人进行随访。结果 :术终 Pp/Ps为 0 .71± 0 .1 8,住院死亡率为 7.1 % (2 /2 8) ,1例因低心排出量脱机困难台上死亡 ,另一例术后 8d死于右心衰竭 ;在随访过程中有 1例因慢性右心衰竭术后 8个月死亡。结论 :完善的围手术期治疗能提高室间隔缺损并重度肺高压的手术成功率 ,术后远期疗效尚待随访研究。Objective:This study was to evaluate the effects of perioperative managements on the outcomes of surgical treatment of ventricular septal defect(VSD)associted with severe pulmonary hypertension(SPH).[WT5HZ]Methods:28 cases of VSD were diagnosed and evaluated via clinical examination,chest X-ray,ECG,UCG,and blood gas analysis.Pulmonary arterial pressure was 70-115/35-63 mmHg,Pp/Ps 0.89±0.14.Oxygen inhalation,oral ACEI,intravenous regitine or prostaglandin E 1(PGE 1) and GIK solusion were administed for 2～3 weeks preoperatively.Operation was performed under CPB and dacron patch were used to repair the VSD.Patients were followed up.[WT5HZ]Results:Postoperative Pp/Ps was 0.71±0.18.The hospital mortality was 7.1%(2/28),one patient died on table due to low output syndrome,another died of righ heart failure 8 days after operation.During follow-up period,one patient died of chronic right heart failure 8 months after operation.[WT5HZ]Conclusion:Proper periopertive management can improve the surgical outcome.Follow-up is needed to investigate the long-term result. [WT5HZ]

关 键 词：空间隔缺损 肺动脉高压 心脏外科手术 

分 类 号：R654.205[医药卫生—外科学] R543.206[医药卫生—临床医学]