肺动脉血栓内膜剥脱术治疗慢性栓塞性肺动脉高压

目的报告肺动脉血栓内膜剥脱术治疗慢性栓塞性肺动脉高压的经验。方法回顾性总结了连续8例肺动脉血栓内膜剥脱术的手术要点、围术期处理以及近中期结果。结果8例均存活。肺动脉收缩压由术前的(101±24)mmHg降至术后的(39±15)mmHg、动脉血氧分压由(59±11)mmHg升至(92±7)mmHg。动脉血氧饱和度由(0.89±0.06)升至(0.98±0.01)，均有显著改善。随访显示患者心功能为纽约心功能协会分级标准(NYHA)Ⅰ级(3例)或NYHAⅡ级(5例)，生活质量明显改善。结论肺动脉血栓内膜剥脱术是治疗慢性栓塞性肺动脉高压的有效手段。

Pulmonary thromboendarterectorny in the management of chronic pulmonary thromboembolic hypertension

OBJECTIVE: The efficacy of surgical treatment (pulmonary thromboendarterectomy, PTE) in the management of chronic pulmonary thromboembolic hypertension (CTE-PH) was reviewed. METHODS: A retrospective study of 8 patients receiving consecutive PTE in Fuwai cardiovascular hospital was made, with special regard to the operation methods, perioperative management and follow-up. RESULTS: All survived the operation. As compared with preoperative values, all patients presented with significant improvement of systolic pulmonary artery pressure [(39 +/- 15) mmHg versus (101 +/- 24) mm Hg], arterial oxygen tension [(92 +/- 7) mmHg versus (59 +/- 11) mm Hg] and arterial oxygen saturation (0.98 +/- 0.01 versus 0.89 +/- 0.06). Mid-term follow-up showed that the cardiac function of the patients fell into NYHA class I (n = 3) or II (n = 5), with significant improvement in quality of life. CONCLUSION: PTE is effective treatment in the management of CTE-PH.