先天性心脏病合并重度肺动脉高压的外科治疗

Surgical Treatment of Congenital Heart Disease Associated with Severe Pulmonary Hypertension

目的 :探讨先天性心脏病 (CHD)合并重度肺动脉高压 (PH)的外科治疗效果和围手术期处理方法。方法 :在体外循环下 ,采用根治性手术治疗先天性心脏病合并重度肺动脉高压患者 5 4例。结果 :全组无死亡病例 ,无术后Ⅲ°房室传导阻滞、心包填塞、二次开胸止血、肾功能衰竭等严重并发症。结论 :综合评价病情、正确掌握手术适应证、充分的术前准备、规范和恰当的围术期处理及手术技术的进步是提高外科治疗成功率的关键。

Objective:To investigate the results and methods of surgical treatment and perioperative management of congenital heart disease (CHD) with severe pulmonary hypertension(PH).Methods:Between Sep 2000 and Aug 2003,surgical correction was undertaken in 54 CHD with severe PH.Among them were artrial septal defect(20),patent ductus ateriosus(3),ventricular septal defect(25),complete artrioventricular canal defects (4),and double outlet of right ventricular (2).The corrective operation was performed via cardiopulmonary bypass.Results:No perioperative death occurred.No serious complications such as Ⅲ° artrioventricular block,cardiac temponade,mediastinal reexploration,and renal failure,occurred.Conclusion:Indication of operation and proper perioperative management should be considered in the surgical treatment of CHD with severe PH.