先天性心脏病合并肺动脉高压患者的麻醉处理

Anesthesia management of patients with congenital heart disease and pulmonary hypertension

肺动脉高压常见于肺血流增多的先天性心脏缺损,其发生率和严重程度与缺损的性质有关。总体而言,肺动脉高压是一类预后很差的综合征,尽管药物治疗有所发展,但至今仍以手术治疗为主。此类手术宜尽早在婴幼儿时期施行,以免病情随年龄增长而恶化。手术及麻醉过程中的很多因素可使肺血管阻力增高,如缺氧、手术刺激、炎性介质等,对于先天性心脏病合并肺动脉高压的患者选择合适的麻醉方式和药物维持循环稳定,防止肺循环阻力进一步增高至关重要。现就国内对先心病合并肺动脉高压患者的麻醉管理的研究进展作一综述。

Pulmonary hypertension （PH） is a most common pulmonary blood flow increased in congenital heart defect,the incidence rate and its severity has to do with defect property. PH is a kind of syndrome with poor prognosis. Although novel drugs have been developed, the treatment of congenital heart disease and pulmonary hypertension is still mainly by operation. This kind of opera- tion should be implemented as soon as possible in infancy, in order to avoid the condition worsening with age. Many factors can cause pulmonary artery pressure to increase, such as hypoxia, operation stimulation, mediators of inflammation, and so on. It is very important for patients with congenital heart disease and pulmonary hypertension to maintain circulation stabilization and prevent further in- crease of pulmonary artery pressure by choosing right anesthesia method and anesthesia drugs. This article reviews the current research of domestic combined anesthesia management of patients with congenital heart disease and pulmonary hypertension..