室间隔缺损并中重度肺动脉高压患者围手术期处理

Perioperative management of the ventricular septal defect with moderate or severe pulmonary hypertension

目的:探讨室间隔缺损并中重度肺动脉高压患者的手术时机及围手术期处理。方法:28例室间隔缺损并中重度肺动脉高压患者,术前给予吸氧、前列腺素E1等药物治疗后均行室间隔缺损修补术,部分重度肺动脉高压患者应用单向活瓣补片修补室间隔缺损。结果:术后死亡2例,其中1例为低心排血量综合征并肺动脉高压危象,1例为低心排血量综合征并肺部感染。余26例安全度过围手术期并痊愈出院。结论:选择手术时机,术中完善手术修复和恰当的围术期处理是室间隔缺损并中重度肺动脉高压患者治疗的关键。

Objective To study the surgical opportunity and perioperative management of the ventricular septal defect with moderate or severe pulmonary hypertension.Methods After medicinal therapy,28 cases of ventricular septal defect received operation.One-way valve patch and further myocardial protection were applied on patients with severe pulmonary hypertension.Results Two patients died after the operation,in which one died of low cardiac output syndrome and pulmonary hypertension crisis,and the other died of low cardiac output syndrome and pulmonary infection.Twenty-six patients went through perioperative period smoothly.Conclusion Proper choice of surgical opportunity,complete surgical repair and good perioperative management are the keys to the successful operation of ventricular septal defect with moderate or severe pulmonary hypertension.