室间隔缺损合并严重肺动脉高压的外科治疗

Surgical treatment of ventricular septal defect complicated by severe pulmonary hypertension

目的探讨室间隔缺损合并严重肺动脉高压的外科治疗效果．方法１９９１年～１９９４年间，手术治疗室间隔缺损合并严重肺动脉高压１９例，室缺均用涤纶补片修补．术后应用血管扩张剂，呼吸机充分供氧．适当过度通气。结果本组发生呼吸窘迫综合征１例，经处理后治愈。手术死亡１例，死亡率为５．２６％．余病人恢复顺利，一般情况良好。结论术后应用血管扩张剂，呼吸机充分供氧适当过度通气．可有效降低肺动脉压。

Objective To study the effect of surgical treatment of ventricular septal defect complicated by severe pulmonary hypertension.Methods From 1991 to 1994, 19 patients suffered from ventricular seDtal defect complicated with severe pulmonary hypertension were operated under extracorporeal circulation middle hypothermia.The defects were closed by using dacron patch. Postoperation usually used vasodilator, ventilator supply enough oxygen and proper over- ventilation.Results One case developed respiratory distress syndrome after operation in this series and cured. Other one dead in operation and the mortality was 5. 26%. The remaining cases were recover smoothly.Conclusion it is good to drop pulmonary arterial pressure by using vasodilator, ventilator suppling oxygen and proper overventilatlon in surgical treatment of ventricular septal defect copmlicated with severe pulmonary hypertension.