在左向右分流的先天性心脏病（先心病）的不同时期，肺动脉高压（简称肺高压）的病理基础是不同的。对血管扩张剂的应用争议较多。本文讨论了肺高压的病理基础和血管扩张剂的作用机制，讨论了在肺高压早、中期，肺高压有无合并心衰，艾森曼格综合征及先心病围手术期等不同情况下血管扩张剂使用的利弊关系。指出区分不同情况合理使用血管扩张剂是提高其疗效的关键。 In different periods of left-to-right shunt congenital heart disease (CHD), the pathological basis of pulmonary hypertension (referred to as pulmonary hypertension) is different. Vasodilator applications more controversial. This article discusses the pathological basis of pulmonary hypertension and vasodilator mechanism of action, discussed in the early and mid-term pulmonary hypertension, pulmonary hypertension with or without heart failure, Eisenmenger’s syndrome and perioperative perioperative vascular under different circumstances The pros and cons of the use of dilators. It is pointed out that the reasonable use of vasodilators in different situations is the key to improve the curative effect.