【摘 要】
：
目的 合并重度肺动脉高压的先天性心脏病患儿在以往被认为其肺血管病变是不可逆的,但是近年来我科的治疗团队应用诊断性治疗策略对这些患者进行了成功的手术矫治并取得了良好的中期随访结果.本研究旨在评价诊断性治疗大龄非限制性室间隔缺损合并重度肺动脉高压患者的中期随访结果.方法 回顾性分析2006至2012年56例6岁以上合并非限制性室间隔缺损和重度肺动脉高压患者诊断性治疗结果.所有的入选患者均使用靶向药物减
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目的 合并重度肺动脉高压的先天性心脏病患儿在以往被认为其肺血管病变是不可逆的,但是近年来我科的治疗团队应用诊断性治疗策略对这些患者进行了成功的手术矫治并取得了良好的中期随访结果.本研究旨在评价诊断性治疗大龄非限制性室间隔缺损合并重度肺动脉高压患者的中期随访结果.方法 回顾性分析2006至2012年56例6岁以上合并非限制性室间隔缺损和重度肺动脉高压患者诊断性治疗结果.所有的入选患者均使用靶向药物减低肺动脉压力,当经皮血氧饱和度(SPO2)＞93％后行根治手术.结果 全组手术无死亡.经过肺高压的靶向药物治疗,SPO2和6分钟步行试验均较治疗前显著改善,平均肺动脉压力也较治疗前显著下降(p＜0.01).术后长期随访,SPO2和6分钟步行试验均较术前显著改善,平均肺动脉压力也较治疗前显著下降.6例患者残留有肺动脉高压,并继续应用靶向药物治疗.通过Logistic回归分析,术后早期肺高压是术后晚期肺高压的独立危险因素.结论 应用靶向治疗药物对大龄非限制性室间隔缺损合并重度肺动脉高压患者进行肺血管阻力的评估及诊断性治疗是安全和有效的,能获得良好的中期效果.
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