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目的 探究外科手术治疗成人先天性心脏病合并冠心病的有效性及安全性.方法 回顾性分析2005年6月-2013年6月驻马店市中心医院25例拟行手术治疗的成人先天性心脏病合并冠心病患者的临床资料,患者均予以心脏畸形矫治联合冠状动脉搭桥手术治疗,观察其桥路总数、动脉桥数、机械通气时间、主动脉阻断时间、住院时间等手术情况,并随访观察其心功能及肺动脉高压改善情况.结果 25例患者共做远端吻合口41个,同期8例行三尖瓣成形术,4例行二尖瓣成形术,2例行二尖瓣人工机械瓣置换术,平均机械通气时间为(72.86±36.49)h,主动脉阻断时间为(19.34±7.56) min,住院时间为(15.24 ±3.57)d;术后平均随访(29.47±5.34)个月,1例患者在术后19个月出现再发心绞痛症状,经药物治疗后好转,均无其他并发症发生,在末次随访时患者心功能I级人数比例76.00％(19/25)与无肺动脉高压人数比例60.00％(15/25)较术前显著升高,心功能Ⅲ级人数比例4.00％(1/25)与肺动脉高压为中度人数比例12.00％(3/25)较术前显著降低,差异均具有统计学意义(P＜0.05).结论 对成人先天性心脏病合并冠心病患者应用外科手术治疗效果显著,可明显改善患者心功能,减轻其肺动脉高压症状,且术后并发症较少,安全有效.“,”Objective To explore the effectiveness and safety of surgical treatment of adult congenital heart disease with coronary heart disease.Methods Totally 25 patients with congenital heart disease complicated with coronary heart disease who underwent surgical treatment were retrospectively analyzed from June 2005 to June 2013 in Zhumadian central hospital of Henan province.Patients were treated with cardiac abnormalities combined with coronary artery bypass surgery,the total number of bridge,arterial bridge number,mechanical ventilation time,aortic block time,length of stay and other surgical conditions were observed,and follow-up to observe the cardiac function and pulmonary hypertension improvement conditions.Results Totally 25 patients including 41 distal anastomoses,8 patients undergoing tricuspid valvuloplasty,4 patients underwent mitral valvuloplasty,2 patients underwent mitral valve replacement,the mean of mechanical ventilation time was (72.86 ± 36.49) h,the duration of aortic occlusion was (19.34 ± 7.56) min,and the hospitalization time was (15.24 ± 3.57)d;The mean follow-up (29.47-± 5.34) months after operation,1 patient had recurrent angina symptoms 19 months after operation,improved after drug treatment,no other complications occurred,at the last follow-up,the proportion of patients with cardiac function grade I 76.00％ (19/25) and 60.00％(15/25) in patients without pulmonary hypertension was significantly higher than that before operation,the ratio of heart function grade Ⅲ 4.00％ (1/25) and the pulmonary hypertension of moderate 12.00％ (3/25) were significantly lower than before surgery(P ＜ 0.05).Conclusion Surgical treatment of adult congenital heart disease with coronary heart disease gets a significant effect,which can improve the cardiac function and alleviate the symptoms of pulmonary hypertension,and the complication is less after treatment,with safe and effective.