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目的 探讨先天性心脏病 (先心病 )伴重度肺动脉高压 (肺高压 )患儿手术指征的判定标准。方法 38例经手术治疗后早期肺动脉压降至正常的患儿作为可逆性肺高压组 (简称RPH组 ) ,1 2例经手术治疗后持续性肺高压的患儿作为不可逆性肺高压组 (简称IPH组 ) ,对比两组血流动力学指标。结果 两组肺 体动脉收缩压比值 (Pp Ps) ,肺 体血管阻力比值 (Rp Rs) ,肺 体循环血流量比值 (Qp Qs)及动脉血氧饱和度 (SaO2 )差异均有显著意义。若判定先心病伴重度肺高压手术指征为下列 5项 :年龄小于 2岁 ,Pp Ps<1 .0 ,Rp Rs<0 .7,Qp Qs>1 .5,SaO2 >0 .9,则本研究中RPH组 38例患儿均符合上述 3项或 3项以上 ,而IPH组仅 1例患儿符合上述 3项指标。结论 先心病伴重度肺高压存在上述 5项指标中3项或 3项以上。判定患儿有手术指征 ,可疑者应进一步作扩血管试验和肺组织病理检查 ,明确手术指征
Objective To investigate the criteria of surgical indication for children with congenital heart disease (congenital heart disease) and severe pulmonary hypertension (pulmonary hypertension). Methods Thirty-eight children who underwent pulmonary embolism were recruited as reversible pulmonary hypertension group (RPH group), and 12 children with persistent pulmonary hypertension after surgery were recruited as irreversible pulmonary hypertension group IPH group), compared two groups of hemodynamic indicators. Results The Pp Ps, Rp Rs, Qp Qs and SaO2 were significantly different between the two groups. If the determination of congenital heart disease with severe pulmonary hypertension indications for the following five items: younger than 2 years of age, Pp Ps <1 .0, Rp Rs <0 .7, Qp Qs> 1, SaO2> 0. In the study, 38 children in the RPH group all met the above three items or three items, while only one patient in the IPH group met the above three criteria. Conclusions There are 3 or more of the above 5 indicators in congenital heart disease with severe pulmonary hypertension. Children with surgical indications were indicted, suspicious persons should be further vasodilatation test and lung histopathology, a clear indication of surgery