先天性心脏病合并肺动脉高压患者的麻醉处理.pdfVIP

· 40· 转《化医学杂~}2014年2月 第3卷第1期 TranslationalMedicineJournal，Vo1．3No．1，Feb2014 先天性心脏病合并肺动脉高压患者的麻醉处理 刘慧杰 [摘要]肺动脉高压常见于肺血流增多的先天性心脏缺损，其发生率和严重程度与缺损的性质有关。总 体而言，肺动脉高压是一类预后很差的综合征，尽管药物治疗有所发展，但至今仍以手术治疗为主。此类手术 宜尽早在婴幼儿时期施行 ，以免病情随年龄增长而恶化。手术及麻醉过程中的很多因素可使肺血管阻力增 高，如缺氧、手术刺激 、炎性介质等，对于先天性心脏病合并肺动脉高压的患者选择合适的麻醉方式和药物维 持循环稳定，防止肺循环阻力进一步增高至关重要。现就国内对先心病合并肺动脉高压患者的麻醉管理的研 究进展作一综述。 [关键词]先天性心脏病；肺动脉高压；麻醉 [中图分类号]R541．1；R543．2 [文献标志码]A [文章编号]2095—3097(2014)01—0040—05 doi：10．3969／j．issn．2095．3097．2014．01．010 Anesthesiamanagementofpatientswith congenitalheartdiseaseandpulmonaryhypertension LIU Huoie (1．InnerMongoliaMedicalUniversity，HohhotInnerMongolia010000，China； 2．DepartmentofAnesthesiology，WulanchabuCentralHospital，WulanchabuMongolia012000，China) [Abstract]Pulmonaryhypertension(PH)isamostcommonpulmonarybloodflowincreased incongenitalheartdefect，theincidencerateanditsseverityhastodowithdefectproperty．PH isa kindofsyndromewithpoorprognosis．Although noveldrugshavebeen developed，thetreatmentof congenitalheartdiseaseandpulmonaryhypertensionisstillmainlybyoperation．Thiskindofopera— tionshouldbeimplementedassoonaspossibleininfancy，inordertoavoidtheconditionworsening with age．ManyfactorscancaHsepulmonary artery pressuretoincrease，suchashypoxia，operation stimulation，mediatorsofinflammation，andSOon．Itisveryimportantforpatientswith congenital heartdiseaseandpulmonary hypertensiontomaintaincirculationstabilizationandpreventfurtherin— creaseofpulmonaryartery pressurebychoosingrightanesthesiamethodandanesthesiadrugs．This articlereviewsthecurrentresearch ofdomesticcombinedanesthesiamanagementofpatientswith congenitalheart diseaseandpulmonaryhypertension．． [Keywords]Congenitalheartdisease；Pulmonaryhypertension；Anesthesia 先天性心脏病