132例室间隔缺损合并重度肺高压外科治疗经验

Surgical treatment of ventricular septal defect complicated by serious pulmonary hypertension

目的：对１３２例室间隔缺损合并重度肺高压患者的手术及围手术期治疗进行回顾性研究和讨论。方法：于体外循环辅助下补片修补室间隔缺损。结果：围手术或死亡１３例（死亡率９．８％）。随访９６例，随访１ａ～１２ａ，随访率７２．７％。随访无远期死亡。９２例（９５．８ ％）恢复良好，心功能达Ⅱ级以上；３例（３．１％）心功能Ⅲ级，活动后心慌、气急；１例（１．０４％）心功能Ⅳ级，活动能力差。结论：空间隔缺损合并重度肺高压患者一经确诊应尽早手术，但如出现艾森曼格氏综合征者不宜手术。完善的手术、合理的围手术期治疗是手术成功的关键。

Objective 132 patients with ventricular septal defect complicated by serious pulmonary hypertension were reviewed to study operation and postoperative care. Method The patient's ventricular septal defect was repaired with path in cardiopulmonary by pass. Results There were 13 patients early died after operated(mortality 9.8%). 96 patients were followed up for 1 to 12 years. The rate of followed up is 72.7%. There was no late death. Excellent results were observed in 92 patients(95.3%).Symptoms had been obviously improved in 2 patients(3.2%).The activity was different in 1 patient. Conclusion The patients with ventricular septal defect complicat- ed by serious pulmonary hypertension are operated early. It is taboo to be operated the patients with Eisenmenger's syndrome. The im- provement in surgical technique. Myocardial protection and postoperative care, the result of operation was important.