摘要
目的 探讨肺减容手术 (LVRS)改善慢性阻塞性肺疾病 (COPD)患者肺功能等的机制。方法 对 2 0例LVRS手术 (切除范围为 2 0 %～ 30 %)患者 ,于手术前及手术后 3个月进行肺功能 (FEV1、RV、TLC)、动脉血气分析 (PO2 、PCO2 )、心脏超声多普勒 (CO、Cl、EF、PAP)等指标的比较分析。结果 LVRS手术后患者的FEV1、RV、TLC等都有明显提高 (P <0 .0 1)。PO2 术后比术前有提高 (P <0 .0 5 ) ,PCO2 显著减小 (P <0 .0 1)。心功能指标 :Cl、CO、EF及肺动脉压力 (PAP)术后 3个月较术前无明显变化 (P >0 .0 5 )。 2 0例患者术后 6min走 (6MWT)为 (2 86± 85 )m ,比术前 (182± 10 2 )m显著增加 (P <0 .0 1)。结论 切除范围在 2 0 %～ 30 %的LVRS可明显改善COPD患者的肺功能 ,提高PO2 ,降低PCO2 ,而对心功能、肺动脉压力影响不明显。
Objective To investigate the mechanism of lung volume reduction surgery on function of lung and pulmonary hemodynamic in COPD.Methods We measured and analyzed lung function(FEV1?RV?TLC),arterial blood gas analysis (PO 2?PCO 2),and color Doppler echocardiography (CO?CI?FS?EF?PAP) in 20 COPD patients before and 3 months after LVRS.Results We found that FEV1?RV?TLC of all patients significantly improved ( P <0.01),and PaO2 increased( P <0.05),but PCO 2 decreased( P <0.01).According to the documents of Doppler echocardiography,there was no statistical difference of cardiac functions (CO?CI?EF?PAP ) between preoperation and postoperation.The 6 minute walking test in 20 patients was (286±85)m,which significantly increased( P <0.01) compared with preoperation[(182±102)m].Conclusions Lung volume reduction surgery (LVRS) has become an extended surgery for chronic obstructive pulmonary disease in order to improve the dyspnea of severely affected patients.After LVRS resected range about 20%～30%,the function of lung improved,PO 2 increased and PCO 2 decreased.However,in this condition the values of PAP and the cardiac function were unchanged,and no significant deterioration of cardiac function was detected.We thought that the mechanism of improvement should be caused by the compensation and revived function of the remaining lung.
出处
《北京医学》
CAS
北大核心
2003年第3期173-175,共3页
Beijing Medical Journal
关键词
肺减容手术
慢性阻塞性肺疾病
动脉血气分析
肺功能
Lung volume reduction sugery Pulmonary hemodynamic Chronic obstructive pulmonary disease(COPD)
