球囊肺血管成形术治疗血栓栓塞性肺动脉高压患者的临床疗效

Effect of balloon pulmonary angioplasty in the treatment of thromboembolic pulmonary hypertension

目的探讨球囊肺血管成形术(BPA)治疗血栓栓塞性肺动脉高压患者的临床疗效。方法收集遂宁市中心医院2017年1月至2020年6月采取BPA手术治疗的80例血栓栓塞性肺动脉高压患者临床资料。统计患者术后并发症发生情况、肺动脉直径(肺动脉主干直径和右肺动脉直径)、肺动脉压[肺动脉收缩压(PASP)、肺动脉舒张压(PADP)和肺动脉平均压(PAPm)]、超声心动图参数(右室基底部横径、右心室前壁厚度、右心房长径、左心房前后径、左心室舒张末内径、左心室收缩末内径、左心室射血分数、右心室收缩末期内径和右心室舒张末期内径)。结果80例患者手术并发症率为6.25%(5/80)。术后1个月,80例患者肺动脉主干直径、右肺动脉直径、PASP、PADP、PAPm较术前降低,差异有统计学意义(P<0.05)。术后3个月,80例患者右室基底部横径、右心房长径、左心房前后径、右心室收缩末期内径、右心室舒张末期内径较术前降低;左心室舒张末期内径较术前升高,差异有统计学意义(P<0.05)。结论血栓栓塞性肺动脉高压患者采用BPA治疗能有效降低肺动脉高压,改善患者心功能,对于临床具有较高的实用价值。

Objective To investigate the effect of balloon pulmonary angioplasty(BPA)in the treatment of thromboembolic pulmonary hypertension.Method The clinical data of 80 patients with thromboembolic pulmonary hypertension who underwent BPA surgery in Suining Central Hospital from January 2017 to June 2020 were collected.Statistics of postoperative complications of patients was made,including diameters of the pulmonary artery(main pulmonary artery and right pulmonary artery),the pressure of pulmonary artery[pulmonary artery systolic pressure(PASP),pulmonary artery diastolic pressure(PADP),and pulmonary artery mean pressure(PAPm)],parameters of echocardiographic(right ventricular basal-diameter,right ventricular anterior wall thickness,right atrium longitudinal diameter,left atrium anteroposterior diameter,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular ejection fraction,right ventricular end-systolic diameter and right ventricle end-diastolic diameter).Result The postoperative complication rate of 80 patients was 6.25%(5/80).One month after the operation,the main pulmonary artery’s diameter,the diameter of the right pulmonary artery,PASP,PADP,and PAPm of 80 patients were lower than those before the operation,and the difference was statistically significant(P<0.05).At three months after the operation,80 patients had lower right ventricular basal diameter,right atrium longitudinal diameter,left atrium anteroposterior diameter,right ventricular end-systolic diameter,and right ventricular end-diastolic diameter lower than those before the operation.The end-diastolic diameter of the left ventricle was higher than that before the procedure.The differences were statistically significant(P<0.05).Conclusion BPA treatment in patients with thromboembolic pulmonary hypertension can effectively reduce pulmonary hypertension and improve the patient’s cardiac function,which has high clinical value.