TY - JOUR T1 -慢性血栓栓塞性肺动脉高压临床情况和手术治疗JF -欧洲呼吸杂志》乔和J SP - 334 LP - 342欧元六世- 5 - 3盟莫泽公里AU -钻、WR AU - Fedullo PF AU -吞云吐雾,SW Y1 - 1992/03/01 UR - //www.qdcxjkg.com/content/5/3/334.abstract N2 -慢性大血管血栓栓塞肺动脉高压(CTEPH),这是一种罕见的情况，在过去，这是尸检的奇闻。诊断方法、外科技术和术后处理的进步已经将这种疾病转变为一种可能治愈的肺动脉高压形式。主要症状为运动时无法解释的呼吸困难。对于这种主诉的患者，应考虑CTEPH。在诊断过程中存在许多陷阱。肺灌注扫描可以明确诊断，但往往低估了中央动脉梗阻的程度。肺血管造影是关键的诊断程序，但血栓组织再通的多种模式需要经验基础才能正确解释。选择手术病人的标准正在发展，但保证血栓可达性手术是至关重要的。 Surgical thromboendarterectomy bears no resemblance to acute pulmonary embolectomy. Recognition of thrombus (versus normal intima), meticulous dissection and a bloodless surgical field are essential for adequate restoration of pulmonary vascular patency. Multiple complications may arise postoperatively, and detailed attention to these is required for patient survival. With a co-ordinated, multi-specialty team effort, however, haemodynamic and clinical outcomes have been rewarding and persist long-term. Surgical mortality should steadily decline with such a co-ordinated effort, as well as earlier diagnosis and advances in surgical and postoperative management techniques. ER -