先心病合并重度肺动脉高压手术麻醉的适应范围和限度

The Indication and Limit of the Anesthesia for the Operations in Congenital Cardiac Diseases with Severe Pulmonary Hypertension

先心病伴重度肺动脉高压（PH）行矫正手术91例，其中危重型PH40例。危重型PH病人的手术适应范围有所扩大。作者提出5项判断术前危险性的标准：1.Pp／Ps≥1.0；2.PVR＞1500dyn·S·cm-5；3.Qp／Qs≤1.2；4.SaO2＜90％；5.存有右向左为主分流时，其4项标准应慎重权衡。

Ninety - one patients of congenital Cardiac diseases with severe pulmonary hypertension were anesthetized for cardiac operations, of Which 40 were high visk cases. The indicationS Of the OPeration for thOSe high risk pulmonary hypertensive patients had been extended. Five indication criteria been considered are: (1) Pp/Ps≥1. 0;(2) PVR> 1500 dyn·s· cm-5; (3) Qp/Qs≤1. 2; (4) SaO2 <90% and (5) all above - mentioned 4 criteria (should be carefully evaluated when the right to left shunt is Predominant.