摘要
先天性体肺分流性心脏病可导致肺循环持续的血流量增加、肺血管收缩和肺血管重构,引起肺动脉压力升高,影响手术治疗的效果。在肺血管病变尚可逆时,手术后患者肺动脉压力下降,预后良好;当肺血管病变严重,手术后肺动脉压力持续升高,预后不良。如何准确判断先天性心脏病合并肺动脉高压患者的手术适应证仍有争议,国内外临床医生和基础研究学者都对先天性体肺分流心脏病合并肺动脉高压患者的手术适应证评估进行了深入研究,对此进行总结综述。
Left to right shunt congenital heart disease results in a consistent increase of blood in puhnonary vascular bed, thus leading to the constriction and remodeling of pulmonary vasculature and an increased pulmonary pressure, which may affect the surgical effect of pa- tients. At early stage, pulmonary vascular disease is still reversible, which guarantees a good prognosis of patients. However, when the pul- monary vascular disease becomes severe, surgical treatment can not benefit patients and may even lead to a higher mortality. The severity and reversibility of pulmonary vasculature is not correlated with the pulmonary resistance or the pulmonary pressure. How to select patients for surgeries remains a clinical controversy confronted with many doctors. This review will provides the latest progress in basic and clinical re- searches to determine the operative indications for selecting patients with pulmonary hypertension associated with congenital heart disease for surgical treatment.
出处
《心血管病学进展》
CAS
2013年第1期59-62,共4页
Advances in Cardiovascular Diseases
关键词
先天性心脏病
左向右分流
肺动脉高压
可逆性
手术指征
congenital heart disease
left to right shunt
pulmonary hypertension
reversibility
operative indication