室间隔缺损修补并同种异体肺移植治疗室间隔缺损合并肺动脉高压一例  

Treatment of ventricular septal defect with pulmonary hypertension with entricular septal defect repair and lung allograft:a case report

作　　者：李丰科[1] 王跃斌[1] 丁志丹[1] 方泽民[1] 赵凯 冯敏[2] 常思远[2] 常薇[2] 刘刚[2] 王勇[3] 金峰[3] 李军[4] 黄明君[4] 张新[5] 罗鸿[5] 张亮[5] 赵高峰[1] LI Fengke;WANG Yuebin;DING Zhidan;FANG Zeming;ZHAO Kai;FENG Min;CHANG Siyuan;CHANG Wei;LIU Gang;WANG Yong;JIN Feng;LI Jun;HUANG Mingjun;ZHANG Xin;LUO Hong;ZHANG Liang;ZHAO Gaofeng(Department of Thoracic Surgery/Lung Transplantation Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,P.R.China;Surgical ICU of The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,P.R.China;Department of Anesthesiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,P.R.China;Invitro Support Center,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,P.R.China;Department of Cardiac Surgery,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,P.R.China)

机构地区：[1]郑州大学第一附属医院胸外科/肺移植外科,河南郑州450052 [2]郑州大学第一附属医院外科ICU,河南郑州450052 [3]郑州大学第一附属医院麻醉科,河南郑州450052 [4]郑州大学第一附属医院体外支持中心,河南郑州450052 [5]郑州大学第一附属医院心脏外科,河南郑州450052

出　　处：《中国呼吸与危重监护杂志》2022年第8期577-580,共4页Chinese Journal of Respiratory and Critical Care Medicine

摘　　要：目的探讨室间隔缺损修补并同种异体肺移植术(简称“修心换肺”)治疗室间隔缺损并重度肺动脉高压的临床疗效。方法受者女,21岁,为室间隔缺损并重度肺动脉高压,在全麻低温体外循环下先右侧开胸行室间隔缺损修补术,后行右肺移植术,更换体位后再行左肺移植术。结果顺利完成手术。术中体外循环支持时间为90 min,出血量为2000 mL。受者术后第2天撤除体外膜肺氧合,第3天撤离呼吸机,第38天康复出院。受者术后心脏彩色多普勒超声提示肺动脉压持续改善。结论对简单的先天性心脏病患者同时合并重度肺动脉高压的患者,“修心换肺”能改善其生活质量。Objective To explore the clinical effect of ventricular septal defect repair and lung allograft(simply as"heart repair and lung transplant")in the treatment of ventricular septal defect complicated with severe pulmonary hypertension.Methods A 21-year-old female patient with ventricular septal defect and severe pulmonary hypertension was treated with cardiopulmonary bypass(CPB)under general anesthesia,and then right lung transplantation was performed,and then left lung transplantation was performed after changing body position.Results The operation was conducted successively.The intraoperative CPB support time was 90 minutes,and the blood loss was 2000 mL.Extracorporeal membrane oxygenation was removed on the second day after operation,the ventilator was evacuated on the third day,and the patient recovered and discharged on the 38th day.Postoperative echocardiography showed significant improvement in pulmonary artery pressure.Conclusion For patients with simple congenital heart disease complicated with severe pulmonary hypertension,"heart repair and lung transplant"can improve their quality of life.

关 键 词：肺移植 肺动脉高压 室间隔缺损 

分 类 号：R655.3[医药卫生—外科学]