Objective To observe the clinical efficacy of alprostadil combined with sildenafil in the treat-ment of perioperative pulmonary hypertension. Methods 80 cardiac surgery patients complicated with pulmonary hy-pertension from January 2012 to January 2013 included 40 cases of congenital heart disease and 40 cases of acquired heart valve disease, and the two groups were randomly divided into the experiment group and the control group. All patients received general treatments such as oxygen, cardiac, diuretics, enlargement of vessel, and improvement of myocardial remodeling in perioperative period, and the observation group was additionally given alprostadil combined with sildenafil before surgery and 7 ~8 days after operation. The echocardiography and arterial blood gas analysis were compared between the two groups after treatment. Results For the four groups, their pulmonary artery, pulmo-nary artery systolic pressure, left ventricular ejection fraction and arterial oxygen tension improved significantly after surgery (P<0. 05), and the improvement was more pronounced in the experiment group than in the control group (P<0. 05). Conclusion For those patients with pulmonary hypertension complicated with congenital heart disease or cardiac valve disease who need heart surgery, cardiac surgery can significantly reduce pulmonary artery pressure and improve heart function. The synergy application of alprostadil and sildenafil can further improve pulmonary hyperten-sion, reduce the patient's symptoms and improve their prognosis.%目的：观察前列地尔联合西地那非，两药物联合应用治疗围手术期肺动脉高压的可行性。方法收集2012年1月至2013年1月我科收治的心脏手术合并肺动脉高压患者80例，其中先天性心脏病40例，后天性心脏瓣膜病40例，并由此分为先心组和瓣膜组，两组再随机分为实验组和对照组。对照组40例围手术期给予吸氧、强心、利尿、扩管、改善心肌重构等常规治疗，实验组在对照组治疗基础上联合前列地尔、西地那非治疗。术前和术后第7~8天分别进行超声心动图检查、动脉血气分析，比较两组疗效差异。结果四组患者手术后肺动脉内径、肺动脉收缩压、左室射血分数、动脉血氧分压指标均有明显改善( P<0．05)，两大组中，实验组较对照组改善均更为显著( P<0．05)。结论对于先天性心脏病或心脏瓣膜病需行心脏外科手术治疗的肺动脉高压患者，心脏手术可明显降低肺动脉压，改善心功能；在心脏围手术期联合应用前列地尔和西地那非，两药协同，可进一步改善肺动脉高压，减轻肺动脉高压患者的症状，改善其预后。
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