CAJ | 학술논문

目的：观察肺功能低下患者电视胸腔镜下肺叶切除术后的肺功能。方法120例肺功能低下患者按照手术方式分为胸腔镜组和开胸组各60例，观察两组手术前后FEV1％、FVC、MVV％及PaO2、PaCO2。结果胸腔镜组术前、术后15 d、术后3个月FEV1％分别为45．0±7．4、51．0±8．2、54．0±9．0，FVC分别为（1．44±0．28）、（1．59±11．20）、（1．63±7．80）L，MVV％分别为53．6±8．2、53．4±9．4、55．2±8．6；开胸组术前、术后15 d、术后3个月FEV1％分别为47．0±7．2、49．0±8．4、53．0±7．8，FVC分别为（1．55±0．21）、（1．58±11．2）、（1．62±7．30）L，MVV％分别为54．7±7．3、48．5±8．7、55．3±8．3；两组术后15 d FEV1％、FVC、MVV％比较，P均＜0．05；开胸组术前与术后15 d FEV1％、FVC、MVV％比较，P均＜0．05。胸腔镜组术前及术后1、2、3 d PaO2分别为（67．5±7．3）、（66．2±9．4）、（67．2±10．2）、（67．7±9．8）mmHg，PaCO2分别为（43．2±5．5）、（43．3±7．6）、（41．2±9．3）、（41．2±8．7）mmHg；开胸组术前及术后1、2、3 d PaO2分别为（68．2±5．5）、（64．3±8．5）、（64．9±9．2）、（65．7±10．6）mmHg，PaCO2分别为（41．3±4．8）、（45．3±8．4）、（44．7±8．6）、（43．2±10．7）mmHg；两组术后1、2、3 d PaO2、PaCO2比较，P均＜0．05。结论与开胸手术者相比，电视胸腔镜下肺叶切除术对肺功能低下患者的肺功能损伤小。
목적：관찰폐공능저하환자전시흉강경하폐협절제술후적폐공능。방법120례폐공능저하환자안조수술방식분위흉강경조화개흉조각60례，관찰량조수술전후FEV1％、FVC、MVV％급PaO2、PaCO2。결과흉강경조술전、술후15 d、술후3개월FEV1％분별위45．0±7．4、51．0±8．2、54．0±9．0，FVC분별위（1．44±0．28）、（1．59±11．20）、（1．63±7．80）L，MVV％분별위53．6±8．2、53．4±9．4、55．2±8．6；개흉조술전、술후15 d、술후3개월FEV1％분별위47．0±7．2、49．0±8．4、53．0±7．8，FVC분별위（1．55±0．21）、（1．58±11．2）、（1．62±7．30）L，MVV％분별위54．7±7．3、48．5±8．7、55．3±8．3；량조술후15 d FEV1％、FVC、MVV％비교，P균＜0．05；개흉조술전여술후15 d FEV1％、FVC、MVV％비교，P균＜0．05。흉강경조술전급술후1、2、3 d PaO2분별위（67．5±7．3）、（66．2±9．4）、（67．2±10．2）、（67．7±9．8）mmHg，PaCO2분별위（43．2±5．5）、（43．3±7．6）、（41．2±9．3）、（41．2±8．7）mmHg；개흉조술전급술후1、2、3 d PaO2분별위（68．2±5．5）、（64．3±8．5）、（64．9±9．2）、（65．7±10．6）mmHg，PaCO2분별위（41．3±4．8）、（45．3±8．4）、（44．7±8．6）、（43．2±10．7）mmHg；량조술후1、2、3 d PaO2、PaCO2비교，P균＜0．05。결론여개흉수술자상비，전시흉강경하폐협절제술대폐공능저하환자적폐공능손상소。
Objective To observe the lung function after video-assisted thoracoscopic lobectomy in patients with low pulmonary function .Methods Totally 120 cases of patients with low pulmonary function were divided into the video-assis-ted thoracoscopic surgery ( VATS) group and the thoracotomy group according to the surgical options , and each group had 60 cases.The FEV1%, FVC, MVV%, PaO2 and PaCO2 in both groups before and after operation were observed .Results In the VATS group, at day 15 before operation, 15 days and 3 months after operation, the FEV1% were 45.0 ±7.4, 51.0 ±8.2 and 54.0 ±9.0;FVC were(1.44 ±0.28), (1.59 ±11.20), (1.63 ±7.80)L, and the MVV%were 53.6 ± 8.2, 53.4 ±9.4 and 55.2 ±8.6.In the thoracotomy group, at day 15 before operation, 15 days and 3 months after opera-tion, the FEV1%were 45.0 ±7.4, 51.0 ±8.2 and 54.0 ±9.0;FVC were (1.55 ±0.21), (1.58 ±11.2) and (1.62 ± 7.30) L;and the MVV%were 54.7 ±7.3, 48.5 ±8.7 and 55.3 ±8.3.Significant difference was found in the FEV 1%, FVC and MVV%at day 15 after operation between the two groups (all P<0.05).Significant difference was found in the FEV1%, FVC and MVV% before and after operation 15 days in the thoracotomy group (all P<0.05).In the VATS group, at 1st, 2nd and 3rd day before and after operation, the PaO2 were (67.5 ±7.3), (66.2 ±9.4), (67.2 ±10.2) and (67.7 ±9.8) mmHg, PaCO2 were (43.2 ±5.5), (43.3 ±7.6), (41.2 ±9.3) and (41.2 ±8.7) mmHg; in the thoracotomy group, PaO2 before operation and after operation 1, 2, 3 d were (68.2 ±5.5), (64.3 ±8.5), (64.9 ± 9.2) and (65.7 ±10.6) mmHg, PaCO2 were (41.3 ±4.8), (45.3 ±8.4), (44.7 ±8.6) and (43.2 ±10.7) mmHg;significant difference was found in the PaO 2 and PaCO2 at 1st, 2nd and 3rd day after operation (all P<0.05).Conclusion Compared with the patients undergoing thoracotomy , the patients with low lung function undergoing VATS lobectomy has less injuries in lung function .