单向活瓣补片在治疗室间隔缺损并重度肺动脉高压疗效分析

Analysis on the difference of pulmonary hypertension after operationg of unidirectional valve patch treating patients with ventricular septal defect and severe pulmonary hypertension

目的探讨单向活瓣补片修补并重度肺动脉高压的室间隔缺损较常规术式区别。方法观察2004年5月至2009年1月期间45例并中重度肺动脉高压的室间隔缺损病人,分为常规手术组和单向活瓣补片手术组,观察两组术后肺动脉压变化,肺动脉压最高值与同时刻桡动脉压比值与呼吸机使用时间关系。结果(1)两组主动脉阻断时间和体外循环时间无明显差异(P>0.05)。(2)最高值肺动脉压与同时刻桡动脉压比值活瓣组明显低于常规组(P<0.05)。(3)最高值肺动脉压与同时刻桡动脉压比值与呼吸机支持时间呈正相关(r=0.386,t=2.71,v=42,P<0.05)。结论单向活瓣补片治疗室间隔缺损合并重度肺动脉高压,缓解肺动脉压升高,降低围手术期风险。

Objective To investigate difference in patients with ventricular septal defect and severe pulmonary hy- pertension to examine its effect on pulmonary hypertension （PH） and to probe into their clinical significance. Methods Between May 2004 and Jan 2009, We selected 45 patients with ventricular septal defect （VSD） and severe pul - monary hypertension. They were randomized into two groups ： the unidirectional valve patch repairing group ang conventional repairing group. We observe the degree of relationship the ratio of pulmonary pressure and radial artery pressure and the ventilative time. Results （ 1 ） the aortic cross - clamp time and the bypass time in the unidirectional valve patch group were no significant diference （ P 〉 0.05 ）. （2） the ratio of pulmonary pressure and radial artery pressure in the conventional repairing group was higher than that in the unidirectional valve. （ 3 ） the ratio of pulmonary pressure and radial artery pressure and the ventilative time was positive correlation. Conclusions The unidirectional valve patch allows a low - risk clouure of large VSD and elevate pulmonary artery pressure.