摘要
目的 探讨肺叶切除术患者围手术期右心室及肺动脉血流动力学变化。方法 对 2 8例接受肺叶切除术的患者 ,应用彩色多普勒超声心动图技术 ,于术前、术后 2～ 4d及术后 8～ 14d ,分别测定反映右心室及肺动脉血流动力学变化的多项指标 ,术前、术后自身对照 ,并进行统计分析。结果 术前测得右心室及肺动脉血流动力学各项指标均在正常范围。术后 2～ 4d ,心率增快 ,右心室每搏输出量及右心室排血量降低 ,肺动脉收缩压、肺动脉舒张压和肺动脉平均压均升高 ,肺血管阻力增加 ,与术前测值比较差异均有显著性意义 ( P <0 .0 5 )。术后 8～ 14d ,各指标测值与术前比较差异均无显著性意义 ( P >0 .0 5 )。结论 肺叶切除患者术后右心室及肺动脉血流动力学有一过性改变。术后 2～ 4d右心室泵功能降低 ,肺动脉压力及肺血管阻力升高 ,而术后 8～ 14d基本恢复至术前水平。
Objective To discuss the hemodynamic changes of right ventricle and pulmonary artery in perioperative pulmonary lobectomy patients, so as to optimize better perioperative managements. Methods Twenty-eight patients undergoing pulmonary lobectomy were examined by colour Doppler echocardiography(CDE) to determine their hemodynamic parameters of right ventricle and pulmonary artery preoperatively, and in postoperative days 2-4 and 8-14. Results There were normal hemodynamic parameters of right ventricle and pulmonary artery measured preoperatively in the study. Comparing with preoperative parameters, there were significant decrease (P< 0.05) of right ventricular stroke volume(RVSV) and right ventricular cardiac output (RVCO) with significant increase (P< 0.05) of heart rate, pulmonary artery systolic pressure (PASP), pulmonary artery diastolic pressure (PADP), pulmonary artery mean pressure (PAMP), and pulmonary vascular resistance (PVR) in the postoperative days 2-4; and there were no significant difference (P> 0.05) of those above mentioned in postoperative days 8-14.Conclusions There were transient hemodynamic changes after pulmonary lobectomy, with decreased right ventricular pumping function and increased pulmonary aterial pressure and PVR in postoperative days 2-4. It was recovered fundamentally in postoperative days 8-14.
出处
《中华超声影像学杂志》
CSCD
2004年第4期266-269,共4页
Chinese Journal of Ultrasonography
关键词
肺叶切除术
围手术期
右心室
血流动力学
肺动脉
超声心动图
Echocardiography,Doppler color
Pneumonectomy
Ventricular function,right
Intraoperative period
