先心病伴严重肺动脉高压矫治术的麻醉处理

目的探讨先心病伴严重肺动脉高压矫治术患者围术期监测及治疗肺动脉高压的麻醉处理。方法选32例肺动脉平均压〉70mmHg的患者，采用主肺动脉置管法持续测压，并通过主肺动脉导管持续泵入前列腺素E1（5μg·kg^-1·min^-1），观察转流后和术后第3天的肺动脉压。结果肺动脉压出院时[（43．90±12．42）mmHg]与术前[（85．88±13．26）mmHg]比较，P〈0．01；术后第3天[（29．40±13．41）mmHg]与术中[（36．10±16．20）mmHg]比较，P〈0．05。结论以动力性为主的严重肺动脉高压患者，虽经外科治疗降低了肺动脉压力，但仍需在麻醉处理上采取必要和有效的措施去预防和治疗肺血管阻力的不断升高。

Anethesia management for the pations of congenital heart disease with severe pulmonary hypertension during the corrective operation

Objective Perioperative management of CHD complicated with severe pulmonary hypertesion and anesthesia intervention. Methods 32 patients with PA pressure no less than 70 mm Hg, cantinuing monitoring of PA pressure via indwelling PA catheter. PG E1 is administered via PA catheter at rate of 5 μg·kg^-1·min^-1 measurements were taken at post aortic clamping ＆ t｜re thirdday postoperation.Results Before discharge vs preopration [ （43.90±12.42）mm Hg vs （85.88±13.26）mm Hg] ,P〈0.01.The thirdday postoperation vs intraopration [ （29.40±13.41 ）mm Hg vs （36.10±16.20）mm Hg],P〈0.05. Conclusion For patients with hyperdynamic severe pulmonary hypertension, effective anesthesia intervention to lower pulmonary vascular resistance is the key to manage patients after surgical correction which leads to decreasing PA pressure.