岑坚正 张镜芳 庄 建 陈欣欣 陈寄梅 510100 广州市 广东省心血管病研究所心外科 岭南心血管病杂志 1999 0 5 3


    关键词：先天性心脏病；肺动脉高压；外科治疗 期刊 lnxxgbzz 0 论著 fur -->


    

【摘要】 目的 报告自1990年1月～1997年11月期间，144例室间隔缺损并重度肺动脉高压患儿的外科治疗结果。方法 全组病例术前均经心导管检查确诊，P_p /P_S (0.81±0.09)，R_p (9.41±5.37)wood。在体外循环下行室缺修补术。结果 手术死亡14例，死亡率9.7%。术前P_P /P_S ≥0.8和R_P ≥10 wood，死亡率达28.6%；存活者中超声检查估测S_P PA>50 mmHg的有32例；1例术后发展成艾森曼格综合征。结论 术前P_P /P_S ≥0.8和/或R_P ≥10 wood的室缺并重度肺动脉高压者手术风险显著增大；婴幼儿室缺并重度肺动脉高压应尽早手术；术后应重视肺动脉高压危象的防治；心内测压管置入对术后并发症有重要作用。

Surgical treatment of 114 children with ventricular septal defect and severe pulmonary hypertension

Cen Jianzheng, Zhang Jingfang, Zhuang Jian, et al. Department of Heart surgery, Guangdong Provincial Institute oa Angiocardiopathy, Guangzhou 510100

【Abstract】 Objective To report the result of surgical treatment for 144 children with ventricular septae defect and severe pulmonary hypertension.Method The diagnosis had been confirmed by cardiac catheter before the operation, P_P /P_S (0.81±0.09) and R_P (9.41±5.37) wood. Ventricular prothesis was performed under extracorporeal circulation. Transthoracic intracardiac monitoring line inserted into pulmonary artery in 117 cases.Results Fourteen cases died of the 144 postoperatively, with mortality of 9.72%. Preoperative P_P /P_S ≥0.8 and R_P ≥10 wood made the mortality higher than that of others (P<0.05). 32 persons had post-operative S_P PA>50 mmHg among the survivers and among the children with Preoperative P_P /P_S ≥0.8 and R_P ≥10 wood the mortality was 28.6% being higher than that among those with P_P /P≥0.08 and R_P <10 wood.Conclusion The higher the preoperative P_P /P_S and R_P are, the higher the surgical mortality is. The prevention and treatment of postoperative pulmonary hypertension crisis should be payed more attention to. The placement of transthoracic intracardiac monitoring lines plays an important role in the prevention and treatment of the complications occurred postoperationally in children with pulmonary hypertension.

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