中华航海医学与高气压医学杂志
中華航海醫學與高氣壓醫學雜誌
중화항해의학여고기압의학잡지
CHINESE JOURNAL OF NAUTICAL MEDICINE AND HYPERBARIC MEDICINE
2008年
6期
356-358
,共3页
肺肿瘤%肺切除术%心脏功能%肺功能
肺腫瘤%肺切除術%心髒功能%肺功能
폐종류%폐절제술%심장공능%폐공능
Lung tumor%Pneumonectomy%Heart function%Lung function
目的 研究老年渔民肺肿瘤肺切除患者在静息及运动负荷状态下手术前后的心肺功能变化规律,为放宽老年肺肿瘤患者手术指征提供依据.方法 41例因患肺肿瘤行肺叶切除术的患者分为老年组24例(≥60岁)、中青年组17例(<60岁),分别于术前3～5 d和术后3～6个月在患者日常生活无障碍时,采用心肺功能仪和多普勒超声技术在静息及运动负荷状态下测定心肺功能,指标包括心率(HR)、左心室舒张末期容积(LVEDV)、每搏量(SV)、心输出量(CO)、左心室射血分数(LVEF)、呼吸频率(RR)、潮气量(VT)、每分通气量(VE)和氧摄取量(VO2),并对其结果进行分析比较.结果 所有患者在静息和运动负荷状态下心功能参数LVEDD和SV术后较术前均有明显降低(P<0.01),静息状态下HR、RR、VT手术前后比较差异有统计学意义(P<0.05或P<0.01).进行年龄分组后,两组在静息状态下术后SV、VT均减小,CO、VE、VO2手术前后差异有统计学意义(P<0.01);运动负荷状态下术后两组VO2均减少,但老年组VE减少明显(P<0.01).结论 肺切除术后静息状态时CO和VE分别通过HR和RR的增加得到补偿,保证了氧摄取量,而术后运动负荷状态下CO和VE的减少不能通过HR和RR得到代偿,老年组VO2降低主要是VE减少所致,而中青年组则是由CO减少所致.
目的 研究老年漁民肺腫瘤肺切除患者在靜息及運動負荷狀態下手術前後的心肺功能變化規律,為放寬老年肺腫瘤患者手術指徵提供依據.方法 41例因患肺腫瘤行肺葉切除術的患者分為老年組24例(≥60歲)、中青年組17例(<60歲),分彆于術前3～5 d和術後3～6箇月在患者日常生活無障礙時,採用心肺功能儀和多普勒超聲技術在靜息及運動負荷狀態下測定心肺功能,指標包括心率(HR)、左心室舒張末期容積(LVEDV)、每搏量(SV)、心輸齣量(CO)、左心室射血分數(LVEF)、呼吸頻率(RR)、潮氣量(VT)、每分通氣量(VE)和氧攝取量(VO2),併對其結果進行分析比較.結果 所有患者在靜息和運動負荷狀態下心功能參數LVEDD和SV術後較術前均有明顯降低(P<0.01),靜息狀態下HR、RR、VT手術前後比較差異有統計學意義(P<0.05或P<0.01).進行年齡分組後,兩組在靜息狀態下術後SV、VT均減小,CO、VE、VO2手術前後差異有統計學意義(P<0.01);運動負荷狀態下術後兩組VO2均減少,但老年組VE減少明顯(P<0.01).結論 肺切除術後靜息狀態時CO和VE分彆通過HR和RR的增加得到補償,保證瞭氧攝取量,而術後運動負荷狀態下CO和VE的減少不能通過HR和RR得到代償,老年組VO2降低主要是VE減少所緻,而中青年組則是由CO減少所緻.
목적 연구노년어민폐종류폐절제환자재정식급운동부하상태하수술전후적심폐공능변화규률,위방관노년폐종류환자수술지정제공의거.방법 41례인환폐종류행폐협절제술적환자분위노년조24례(≥60세)、중청년조17례(<60세),분별우술전3～5 d화술후3～6개월재환자일상생활무장애시,채용심폐공능의화다보륵초성기술재정식급운동부하상태하측정심폐공능,지표포괄심솔(HR)、좌심실서장말기용적(LVEDV)、매박량(SV)、심수출량(CO)、좌심실사혈분수(LVEF)、호흡빈솔(RR)、조기량(VT)、매분통기량(VE)화양섭취량(VO2),병대기결과진행분석비교.결과 소유환자재정식화운동부하상태하심공능삼수LVEDD화SV술후교술전균유명현강저(P<0.01),정식상태하HR、RR、VT수술전후비교차이유통계학의의(P<0.05혹P<0.01).진행년령분조후,량조재정식상태하술후SV、VT균감소,CO、VE、VO2수술전후차이유통계학의의(P<0.01);운동부하상태하술후량조VO2균감소,단노년조VE감소명현(P<0.01).결론 폐절제술후정식상태시CO화VE분별통과HR화RR적증가득도보상,보증료양섭취량,이술후운동부하상태하CO화VE적감소불능통과HR화RR득도대상,노년조VO2강저주요시VE감소소치,이중청년조칙시유CO감소소치.
Objective To investigate the cardiopulmonary function in the old patients with lung tumor resection at rest and during maximum exercise by echocardiography. And provide more suitable operation-index for lung tumor. Methods A total of 41 patients with lung tumor who had undergone lung resection were divided into two groups: the elder patients group ( ≥60 years) containing 24 cases while the middle-younger patients group ( < 60 years) containing 17 cases. When they behaved themselves normally in their daily lives, the cardiopulmonary function were monitored by cardiopulmonary functional instrument and echocardiography from 3～5 days preoperatively and 3～6 months postoperatively. Heart rate ( HR) , left ventricular end - diastolic volume (LVEDV), stroke volume (SV) , cardiac output (CO), Left ventricular ejection fraction (LVEF), respiration rale (RR) , tidal volume (VT) , minute ventilation (VE) , and oxygen consumption (VO(2) ) were observed and analyzed. Results Levels of LVEDV and SV were decreased after operation both at rest and undermovement (P<0.01). The were statistical significance of HR, RR, VT at rest and RR, VT, VE, VO(2), CO during movement before and after operation (P<0. 05 or P<0.01). After being divided into two groups, SV and VT afteroperation were decreased in both groups at restwhile. CO, VE and VO(2) showed statistical siginificance before and after operation. VO(2) was decreased in both groups postoperatively undermovement. VE was decreased in the elder patients group. Conclusions At rest, contents of CO and VE after operation were preserved by the increment of HR and RR, the decrement of CO and VE were not compensated by HR and RR. In older patients group, postoperative decrease of VO(2) was mainly due to VE decreasing while inmiddle-younger patients group, it was due to CO lowering.
