合并肺动脉高压房间隔缺损体外循环手术治疗分析

Analysis for effects of cardiopulmonary bypass on patients with pulmonary hypertension and atrial septai defect

目的随着介入技术的日臻完善，多数房间隔缺损可以通过介入治疗取得满意的效果，但仍有部分房间隔缺损不能介入治疗。对近年来不能介入治疗而实施体外循环手术治疗的成年合并肺动脉高压房间隔缺损的病例进行分析。方法选取成年合并肺动脉高压房间隔缺损患者15例，总结分析术前、术中、术后处理。对患者进行3个月、6个月、1年随访。随访内容包括：体检、x线心脏拍片、心脏超声、心电图检查，了解手术效果。结果患者手术效果良好，无死亡及并发症，术后恢复满意。半年内患者心功能均达到Ⅱ级；X线胸片：肺充血改善，心胸比率缩小。超声检查：肺动脉压力下降。结论对不能介入治疗的合并肺动脉高压的房间隔缺损，体外循环手术仍然是安全有效的重要手段。

Objective With the improvement of interventional technique, most atrial septal defect can be effec- tively improved through this technique. This study aims to analyze the cases with pulmonary hypertension and atrial septal defect who can not be conducted interventional treatment and selected cardiopulmonary bypass. Methods Fifteen patients with pulmonary hypertension and atrial septal defect were selected, and analyzed the intraoperative treatment, before opera- tive treatment postoperative treatment. Three months follow up, 6 months follow up and 1 year follow up were conducted; the follow up included physical examination, X-ray film heart, cardiac ultrasound, ECG. Results The surgery were satis- factory with no death and complications. The cardiac function of patients reached grade Ⅱ within six months; X-ray： pul- monary congestion and improve cardiothoracic ratio reduced. Ultrasound： pulmonary artery pressure decreased. Conclu- sions Cardiopulmonary bypass surgery is a safe and effective method for patiens with pulmonary hypertension and atrial septal defect, and can not be conducted interventional treatment.