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| 肺动脉高压的围术期管理进展 |
| Perioperative management progress of pulmonary hypertension |
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| DOI：10.12089/jca.2022.06.019 |
| 中文关键词: 肺动脉高压 右心衰竭 麻醉 围术期 |
| 英文关键词: Pulmonary hypertension Right ventricular failure Anesthesia Perioperative period |
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| 摘要点击次数: 1939 |
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| 中文摘要: |
| 肺动脉高压（PH）是指由多种病因和不同发病机制所致的静息状态下肺动脉平均压≥25 mmHg（经右心导管测定）的病理状态。任何引起左心房压力（LAP）升高、心输出量（CO）和肺血管阻力（RVR）增加的因素均可导致PH。PH患病率约为1%，与围术期发病率和死亡率相关。PH患者术前风险评估决定于PH分类、PH功能分级和运动耐量、右心功能状态、合并症及手术风险等诸多因素。右心衰竭（RNF）和PH密切相关，PH患者的围术期管理需要通过改善右心室功能和降低肺血管阻力来优化右心室-肺动脉耦联。本文就PH的定义、分类、病理机制及围术期麻醉管理等方面的研究进展予以综述，为PH患者围术期管理提供参考。 |
| 英文摘要: |
| Pulmonary hypertension (PH) is a pathology defined as mean pulmonary arterial pressure (mPAP) ≥ 25 mmHg measured by right heart catheterization at rest. It was caused by multiple etiologies and different pathogenesis. Any factor that result in an increase in left atrial pressure (LAP), cardiac output (CO) or pulmonary vascular resistance (PVR) can lead to PH. PH affects approximately 1% of the global population and is associated with significant perioperative morbidity and mortality. Preoperatively, patients with PH should be appropriately risk stratified based on the type of PH, functional class, exercise capacity, right ventricular dysfunction, comorbidities and the risk of surgery. Right ventricular failure (RVF) closely associated with PH. Perioperative management of patients with PH requires optimizing ventricular-to-pulmonary artery coupling by improving right ventricular function and lowering pulmonary vascular resistance. This article reviews the research progress of definition, classification, pathological mechanism to provide strategic approaches for perioperative management of PH by a multidisciplinary team. |
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