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目的 探讨单向活瓣式补片在治疗室缺合并肺动脉高压中的作用。方法 自 2 0 0 1年 1月～ 2 0 0 2年 12月应用单向活瓣式补片治疗室缺合并严重肺动脉高压患者 10例。平均肺动脉压为 6 0～ 90mmHg[(72± 11)mmHg],动脉血氧饱和度 0 .89～ 0 .95 (0 .92± 0 .0 4 )。结果 术后 4 8h均顺利脱离呼吸机 ,无早期死亡。随访 1～ 2 4个月 ,活瓣均已关闭 ,平均肺动脉压降至 15～ 30mmHg[(2 0± 5 )mmHg],动脉血氧饱和度升至 0 .95～ 0 .98(0 .96±0 .0 2 ) ,术后早期无肺高压危象发生 ,术后晚期症状均明显缓解消失。结论 单向活瓣式补片治疗室缺合并严重肺动脉高压 ,有利于渡过术后肺动脉高压危象期 ,能预防右心功能不全的发生 ,降低手术死亡率。
Objective To investigate the role of unidirectional valve-flap in the treatment of ventricular enlargement and pulmonary hypertension. Methods From January 2001 to December 2002, 10 patients with ventricular aneurysm and severe pulmonary hypertension were treated with one-way valve replacement. Mean pulmonary arterial pressure was 60-90 mmHg [(72 ± 11) mmHg] and arterial oxygen saturation ranged from 0.89 to 0.95 (0.92 ± 0.04). Results 48 h after surgery were successfully removed from the ventilator, no early death. The follow-up of 1 ~ 24 months, the valve has been closed, the average pulmonary artery pressure dropped to 15 ~ 30mmHg [(20 ± 5) mmHg], arterial oxygen saturation rose to 0.95 ~ 0.98 (0.96 ± 0 .0 2). No risk of pulmonary hypertension occurred in the early postoperative period, and the postoperative symptoms were significantly relieved and disappeared. Conclusion One-way valve-type patch for the treatment of ventricular septal defect with severe pulmonary hypertension is conducive to survive the postoperative period of pulmonary hypertension crisis, can prevent the occurrence of right ventricular dysfunction, reduce operative mortality.