106例成人继发孔型房间隔缺损合并肺动脉高压手术患者的临床分析与治疗体会

目的 总结成人继发孔型房间隔缺损继发肺动脉高压的临床特点及围术期处理原则.方法 对我院自2005年3月至2006年6月期间收治的106例成人继发孔型房间隔缺损继发肺动脉高压手术患者的临床资料进行回顾性分析.结果 所有患者均在体外循环下行ASD修补术及合并畸形矫治,其中93例同时行三尖瓣瓣环成形术.术后恢复顺利,全组无死亡.结论 随着年龄的增长,肺动脉高压程度逐渐加重.肺动脉压力超过40mmHg,患者CPB时间、呼吸机应用时间、强心药物及扩血管药物使用时间及ICU治疗时间明显延长.术后延长呼吸机辅助时间、维持一定程度的过度通气、一氧化氮吸入及肺血管扩张药物的应用均是治疗术后肺动脉高压、预防肺动脉高压危象的重要手段.

Study and treatment of 106 patients with secondary atrial septal defect combined with pulmonary hypertension in adult undergoing cardiac surgery

Objective Summarize clinic characteristic and treatment principle of patients with secundum atrial septal defect with pulmonary hypertension in adult pre-and post-operation, Methods The Retrospective Analysis of 106 Cases of secundum atrial septal defect with pulmonary hypertension in adult in my hospital from 2005.03 to 2006.06. Results 106 patients all by ASD repaired and abnormality corrected under extracorporeal Circulation. Among then 93 patients underwent tricuspid valve plasty, Conclusions Pulmonary hypertenfion increasing along with that of the age. While pulmonary hypertention excessive 40mmHg, The period of CPB, ap- plication ventilator, using car-diotoniedrugs and vasodilatation-drugs and treatment time in ICU greatly extend, Longer ventilator support time, hyperventilafion, inhaled nitric oxide, administrated the pulmonary vascular dilators lower pulmonary hypertension and the mortality of pulmonary hypertension crisis.