先天性心脏病合并重度肺动脉高压的围术期处理

The perioperative management of the congenital heart disease and severe pulmonary hypertension

目的 :探讨先心病合并重度肺动脉高压的围术期处理。方法 :2 0 0 1年 9月至 2 0 0 3年 6月 19例先心病合并重度肺动脉高压的患者在术前、术中、术后给予加强心肺保护的综合措施 ,如吸氧、静脉注射前列腺素E1、采用膜肺、适当延长呼吸机支持时间等。结果 :全组 19例患者围术期 1例因右心衰死亡 ,死亡率5 2 6%。其余患者术后心功能不同程度改善 ,与术前相比有明显差异 (P <0 0 5 )。结论

Objective: To study the problems on the perioperative management of the congenital heart disease and severe pulmonary hypertension.Methods: From September 2001 to June 2003,19 patients received surgical repairs under cardiopulmonary bypass.During the perioperating time,they all received a set of treatments,such as oxygen,injecting PGE 1,using membranous oxygenation,and longer the ventilation support time.Results: Only 1 case died of right heart failure.The perioperative mortality was 5.26%.The heart function of the other cases was improved markedly.Conclusion: Combined managements can significantly decrease the perioperative mortality.