先天性心脏病合并肺动脉高压的围术期综合处理

【目的】降低先天性心脏病合并肺动脉高压患者术后早期并发症和死亡率，进一步提高其治疗效果。【方法】总结手术治疗265例先天性心脏病合并中度以上肺动脉高压患者的围术期治疗经验，分析了其术前、术后处理、手术技术，特别是术后降低肺动脉压综合疗法等对预后的影响。【结果】265例术后发生早期并发症者85例，占32.1%，住院死亡42例，占15.8%。采取围术期综合处理方法后，结果明显改善。【结论】对先天性心脏病合并肺动脉高压患者术前改善心功能、降低肺动脉压；术中彻底矫正畸形和缩短缺血时间；术后采用综合疗法降低肺动脉压等围术期综合处理方法是减少术后并发症、降低死亡率的关键。

The Perioperative Integrated Treatment for Patients with CongenitalHeart Disease Associated with Pulmonary Hypertension

【Objective】 To improve the effectiveness of treatment of patientssuffering from congenital heart disease associated with pulmonary hypertension and to decrease the postoperative complications and mortality rate. 【Methods】 265 cases of patient with congenital heart disease associated with pulmonary hypertension were reviewed, the effect of perioperative management, operation approaches and integrated treatment were analyzed. 【Results】 Among 265 cases, 85 cases developed early complications which ranks 32.1%, in which 42 cases died in hospital with mortality rate of 15.8%. The results were improved after giving the integrated treatment during perioperation. 【Conclusion】 It′s important to improve preoperative cardiac function, to correct deformity thoroughly and hold down ischemic time during operation and to depress pulmonary press by integrated treatment during perioperation for reducing the complications and mortality.