先天性心脏病合并重度肺动脉高压外科治疗远期随访  

A long-term follow-up investigation for the repaired congenital heart defects with severe pulmonary hypertension

作　　者：杨盛春[1] 周其文[1] 陈英淳[1] 来永强[1] 韦华[1] 

机构地区：[1]首都医科大学附属北京安贞医院心外科

出　　处：《中华胸心血管外科杂志》2002年第4期199-201,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　探讨先天性心脏病 (先心病 )合并重度肺动脉高压者术前肺血管阻力 (PVR)、肺体循环血流量比 (QP/QS)与术后远期效果的关系。方法　 1 987年 6月到 1 999年 6月间手术治疗且资料完整的合并重度肺动脉高压的先心病病例共 349例 ,30 5例生存。对全部生存病例进行随访 ,对 2 94例有效随访结果 ,用统计学方法分析其术前PVR、QP/QS 和术后远期生活状况、肺动脉高压状况之间的关系。同时与住院未手术病例进行对照研究。结果　术前PVR≥ 1 2 0kPa·L- 1 ·s- 1 或QP/QS<1 2 5的病例 ,术后保持优良状况的生存率曲线明显降低 (P <0 0 5) ;术后生存曲线与未手术组差异无显著性。结论　PVR≥ 1 2 0kPa·L- 1 ·s- 1 或QP/QS<1 2 5者先心病术后远期疗效较差 ,表明此值为临界状态 ,高于此值者 。Objective: To investigate the relationship between the long term outcomes of surgical treatment and preoperative pulmonary vascular resistance (PVR) or pulmonary to systemic flow ratio (Qp/Qs) in patients of congenital heart defects (CHD) with severe pulmonary hypertension (PH). Methods: Between June 1984 and June 1996, 305 cases of CHD with severe PH were followed up. An investigation was made to find out the long term outcomes of all the survivors, and the preoperative PVR and Qp/Qs of the survivors. Results: In cases with preoperative PVR≥120?kPa·L -1 ·s -1 or Qp/Qs<1 25, the survival rate curve declined sharply, and was comparable to that of non operated group. Conclusion: Both preoperative PVR ≥120?kPa·L -1 ·s -1 or Qp/Qs<1 25 are poor predictive factors for patients with CHD associated with PH. The long term outcomes for these patients are not optimistic.

关 键 词：先天性心脏缺损 肺性高血压 外科手术 治疗 

分 类 号：R654.2[医药卫生—外科学]