先天性心脏病合并肺动脉高压术后近期疗效分析

目的探讨影响左向右分流先心痛（left to ringht shunt congenital heart disease，LRCHD）合并肺动脉高压（pulmonary arterial hypertension，PAH）手术近期效果的因素。方法通过对过去10年299例先心病合并充血性肺动脉高压患者可能导致术后近期死亡的影响因素进行回顾性多因素分析。结果229例中，早期死亡15例，病死率6．55％。术前肺动脉压分级、手术时间和肺高压危象对充血性肺动脉高压患者术后近期死亡的影响差异有统计学意义（P〈0．05）。且均是影响患者术后近期死亡的危险因素。结论术前肺动脉压分级、手术时间和肺高压危象是充血性肺动脉高压患者心脏外科手术术后近期死亡的危险因素。

Multivariate Analysis of the Short-term Outcome of Surgical Treatment of Congestive Pulmonary Arterial Hypertension

Objective To evaluate the risk factors of the short- term outcome of surgical treatment of left to right shunt congenital heart disease with congestive pulmonary arterial hypertension through regressive multivariate analysis in the past ten years. Methods 229 cases of L-RCHD with congestive PAH who underwent surgical treatment were eligible for entry into the study. Results In the group 15 cases died and the early mortality was 6.55%. Effects of preoperative pulmonary arterial systolic pressure classification, operation time and pulmonary hypertensive crisis were statistically significant on the early death of L-RCHD with congestive PAH after surgical treatment （P 〈 0.05）. Conclusion Preoperative pulmonary arterial systolic pressure classification, operation time and pulmonary hypertensive crisis are risk factors of postoperative early death of L-RCHD with congestive PAH.