肺动脉血栓内膜剥脱术治疗慢性栓塞性肺动脉高压

摘要

Objective The efficacy of surgical treatment(pulmonary thromboendarterectomy,PTE)in the management of chronic Pulmonary thromboembolic hypertension (CTE-PH) was reviewed. Methods A retrospective study of 8 patients receiving consecutive PTE in Fuwai cardiovascular hospital was made,with special regard to the operation methods,perioperative management and follow-up.Results All survived the operation.As compared with preoperative values,all patients presented with significant improvement of systolic pulmonaryartery pressure [(39±15) mmHg versus (101±24)mm Hg],arterial oxygen tension [(92±7)mmHg versus (59±11)mm Hg]and arterial oxygen saturation (0.98±0.01 versus 0.89±0.06). Mid-term follow-up showed that the cardiac function of the patients fell into NYHA class Ⅰ(n=3)or H (n=5),with significant inprovement in quality of life.Conclusion PTE is effective treatment in the management of CTE-PH.%目的 报告肺动脉血栓内膜剥脱术治疗慢性栓塞性肺动脉高压的经验。方法 回顾性总结了连续8例肺动脉血栓内膜剥脱术的手术要点、围术期处理以及近中期结果。结果 8例均存活。肺动脉收缩压由术前的(101±24)mm Hg降至术后的(39±15)mm Hg、动脉血氧分压由(59±11)mm Hg升至(92±7)mm Hg。动脉血氧饱和度由(0.89±0.06)升至(0.98±0.01)，均有显著改善。随访显示患者心功能为纽约心功能协会分级标准(NYHA)Ⅰ级(3例)或NYHAⅡ级(5例)，生活质量明显改善。结论 肺动脉血栓内膜剥脱术是治疗慢性栓塞性肺动脉高压的有效手段。