【摘要】 目的探讨深低温间断停循环下肺动脉血栓内膜剥脱术治疗慢性肺动脉栓塞的临床效果。方法6例患者均在深低温分次停循环下经主肺动脉及左、右肺动脉切开行肺动脉血栓内膜剥脱术,手术清除段肺动脉开口以上视野可及范围内全部血栓内膜。结果1例因术后急性灌注性肺水肿死亡,5例术后存活。肺动脉收缩压由术前的88-110mmHg(1mmHg=0.133kPa)下降至42-52mmHg,同位素扫描肺血流灌注明显改善,肺动脉栓塞症状消失,心功能恢复至1级。结论深低温间断停循环下肺动脉血栓内膜剥脱术是治疗慢性肺动脉栓塞的手术有效方法。更多还原

【Abstract】 Objectives To identificate the effect of surgical treatment of chronic pulmonary thromboembolism. Methods Six cases received thromboendarterectomy through pulmonary artery under deep periodically hypothermic circulatory arrest, clearing the pulmonary thrombi in the eye field. Results Five patients survived after the operation and were followed up for 6 and 18 months respectively. The pulmonary artery systolic pressure (PASP) decreased from 80-110 mm Hg (before operation)to 42-52 mm Hg (after operation). Symptoms including effort dyspnea disappeared and cardiac function resumed from NYHA class Ⅲ-Ⅲ to NYHA class Ⅰ. One case died from respiratory failure at 66 hours postoperatively. Conclusions Pulmonary thromboendarterectomy is the effective for chronic pulmonary thromboembolism.更多还原