慢性肺动脉栓塞的外科治疗

Surgical treatment of chronical thromboembolic pulmonary hypertension

目的为提高慢性肺动脉栓塞性肺动脉高压的外科治疗水平。方法总结３例由作者进行的肺动脉血栓内膜剥脱术的成功经验。结果３例均术后存活至今，术后肺动脉压力由术前的９０～１００／３０～４０ｍｍＨｇ（１ｍｍＨｇ＝０．１３３ｋＰａ）降至４０～５０／２０～３０ｍｍＨｇ，肺动脉栓塞症状消失，心功能恢复至Ｉ级。结论肺动脉血栓内膜剥脱术是治疗肺动脉栓塞所致肺动脉高压的有效方法。

Objective To improve surgical treatment to chronic thromboembolic pulmonary hypertension. Methods Three cases of successful pulmonary thromb endarterectomy were reviewed to evaluate the indication, operation technique and postoperative treatment. [ Results All 3 patients survived after the operation and were followed up for 2,15 and 18 months respectively. The pulmonary artery pressure (PAP) decreased from 90 100/30 40 mm Hg (before operation)to 40 50/20 30 mm Hg after operation; symptoms including effort dyspnea disappeared and cardiac function resumed from NYHA class Ⅲ Ⅳ to NYHAclass I. Conclusion Pulmonary thromb endarterectomy is effective treatment to chronic thromboembolic pulmonary hypertension.