先天性心脏病重度肺动脉高压肺动脉灌注的临床探讨

Clinical Study of Pulmonary Artery Perfusion for Treatment of Congenital Heart Disease with Pulmonary Hypertension

目的 探讨肺动脉灌注对治疗重度肺动脉高压的作用。方法 对 11例重度肺动脉高压患者 (肺动脉压为 110～ 133 6 0～ 78mmHg ,平均 82～ 10 0mmHg) ,术中用含抑肽酶等药物的肺保护液 ,进行肺动脉灌注。结果 11例病人中死亡 1例 ,余术后恢复良好 ,顺利出院。结论 肺动脉灌注进行肺保护为临床治疗重度肺动脉高压开辟了一种新途径。

Objective To evaluate effect of pulmonary artery perfusion for treatment of congenital heart disease with pulmonary hypertension during cardiopulmonary hypass (CPB). Methods 11 patients with severe pulmonary hypertension (pulmonary pressure 110～133/60～78 mm Hg, mean pressure 82～100 mm Hg) underwent cardiac surgery by the general anesthesia and CPB. Lung protection was performed by pulmonary artery perfusion with hypothermic solution containing aprotinin. Results There was one operative death with a mortality rate of 9%. 10 patients recovered eventually and were discharged. Conclusion Pulmonary artery perfusion is a simple and effective method for lung protection during open heart surgery. It could decrease pulmonary vascular resistance, reduce the right ventricle after load, shorten the time of assistant ventilation, decrease the morbidity of pulmonary hypertention crisis and right heart failure.\;