成人动脉导管未闭合并慢性肺血栓栓塞的外科治疗

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1、AbstractResultsAllpatientswereundergoneeitherSutureorligationofthepatemductusarteriosisandpulmonaryembolectomyorpulmonarythromboendarterectomy(PTE)晰mlowperfusionflowford。印hypothen-o_iacirculatoryarrest．AppropriatelTeatrnentWaSdoneforthosecomplicatedbyotherintracardiaeanomalies．Alprosta

2、dilcontinuously—pumpingwasconductedduringtheoperation．Andbrainprotection,anti—infection，cardiac，diuretic，anticoagulantandothersymptomatictreatmentweregivenroutinelyafteroperation．Onepatientdeadduetoacutelunginjuryandother25patientssurvived．Rexaminationimagingtestresultspostoperativesug

3、gestedthatpulmonaryarterytrunkaswellasitsleftandrightbranchesofthe25patientsfilledwell．Followedup2monthsto10yearsaftertheoperations，7caseslostcontact；3patientswerefoundmoderatetricuspidvalveinsufficiency；nothingseriousWasfoundinothers．ThepulmonaryarterypressuredecreaSed31～55mmHg；clinic

4、alsymptomswererelievedwithoutanysignificantcomplications，patients’exercisecapacityandheartfunctionhadimprovedthanbefore．Conclusion1．Existenceofpatentductusarteriosusinadultsforalongtermleadsdamagetothepulmonaryarterywalls，causingpulmonaryhypertension．Atthesametime,c栅omchypoxiaandotherf

5、actorsincre觞ehemoglobincausingslowedvenousbloodflowand,thenhighbloodviscos畸，whichistheimportantmechanismofpatentductusarteriosuscombinedwithcllromcpulmonarythromboembolisminadults．2．Pulmonaryarterographiesisthebestchoicetodiagnosepatentductusarteriosuscombinedwithchromcpulmonarythrombo

6、embolism．Echocardiographyandcontrast．．enhancedCTareveryimportantforclinicalscreeningofthedisease．D．dimer,fibrinogenandotherlaboratorytestresultssupplyimplicationstothediagnosticwork．3．surgicaltreatmentCaneffectivelydecre髂epulmonaryhypertensionofadultswithIVAbstractPDAcombinedwithchroni

7、cpulmonarythromboembolismandrelieveclinicalsymptoms；tissueofadults而mPDAcharacteristicsadhesionsandcalcification，SObecarefultochoosetheoperationmethods，andbegentlewhenoperating．Todealwellwithlungreperfusionpulmonaryedemaandothercomplicationsinjuryinperioperativeperiodisthekeytoensuret