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目的：探究房水平单向活瓣式补片对老年先天性心脏病伴重度肺动脉高压患者的作用疗效。方法：选取我院心血管科收治的先天性心脏病伴重度肺动脉高压患者80 例，随机分为对照组和实验组。对照组40例，予以常规基础药物治疗（波生坦）；实验组，在基础药物治疗两个疗程后，采用房水平单向活瓣式补片进行手术治疗。比较两组患者治疗前后的肺动脉压（PAP）、体动脉压（SAP）、肺动脉压/ 体动脉压（PAP/SAP）、动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）及吸氧浓度、右室收缩末期内径变化情况。结果：治疗后，与对照组比较，实验组肺动脉压下降幅度较大（P＜0.05）；与治疗前比较，实验组肺动脉压与体动脉压的比值显著下降，且优于对照组（P＜0.05）；治疗后，实验组动脉血氧分压、二氧化碳分压以及吸氧浓度显著优于对照组（P＜0.05）；治疗后，实验组患者右室收缩末期内径显著小于对照组（P＜ 0.05）；随访结果：实验组死亡1 例、术后活瓣坏死2 例、其余37 例病情均转好且无复发情况；对照组死亡4 例、出现各项并发症16 例、剩余20 例病情转好。结论：房水平单向活瓣式补片法可有效改善患者的肺动脉压、体动脉压、动脉血氧分压、二氧化碳分压及吸氧浓度、右室收缩末期内径及6 min 步行距离，对老年先天性心脏病伴重度肺动脉高压患者疗效显著。

英文摘要:

Objective:To investigate the clinical analysis of real level of unidirectional valve patch of congenital heart disease with severe pulmonary hypertension in elderly patients.Methods:80 patients with congenital heart disease with severe pulmonary hypertension from our hospital were selected and randomly divided into control group and experimental group. The control group, 40 cases with medications on a regular basis (temple), one month before the 70.25 mg. Po. The bid, and then to 125 mg. Po. The bid, all round for a period of treatment, medication two period of treatment; The experimental group, in basic drugs after 2 courses of treatment, living room level uni-directional disc type patch for surgery. Compare two groups of patients before and after treatment of pulmonary artery pressure (PAP), arterial pressure (SAP), pulmonary artery pressure/body arterial pressure (PAP/SAP), arterial blood oxygen partial pressure (PaO2), CO2 partial pressure (PaCO2) and oxygen concentration, changes in right ventricular end systolic diameter and 6 min walking experiment comparison; Follow-up after treatment.Results:(1) after treatment, the experimental group, pulmonary artery pressure drop significantly greater than the control group, the difference was statistically significant (P<0.05); The experimental group pulmonary artery pressure and the ratio of arterial pressure dropped significantly, and better than the control group(P<0.05); after treatment, the experimental group arterial blood oxygen partial pressure, CO2 partial pressure and oxygen concentration significantly better than control group(P < 0.05); after treatment, the experimental group patients with right ventricular end systolic diameter was significantly less than the control group, the difference was statistically significant (P<0.05); follow-up results fromthe study: death in 1 case, postoperative flap necrosis in 2 cases, the rest of the 37 cases of the disease are better and no recurrence; Control group died 4 cases, 16 cases appeared various complications, the remaining 20 cases of illness.Conclusion:Room level one-way flapper type patch method can effectively improve, arterial pressure, pulmonary artery pressure in patients with arterial blood oxygen partial pressure, concentration of carbon dioxide and oxygen partial pressure, right ventricular end systolic diameter and 6 min walking distance, the congenital heart disease for the elderly patients with severe pulmonary hypertension with curative effect is remarkable.

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