摘要
目的：探讨食管癌病人术前肺功能与双腔管全麻双侧和单侧通气状态下气道阻力的相关性。方法：９３例食管癌病人依据术前肺功能分为３组；正常组５１例（％ＶＣ≥８０％、％ＦＥＶ１≥７０％、％Ｖ２５／ＨＴ≥５０％），轻度异常组１５例（％ＶＣ≥８０％、％ＦＥＶ１≥７０％、％Ｖ２５／ＨＴ为４５％～４９％）；重度异常组２７例（％ＶＣ≥８０％、％ＦＥＶ１＜７０％、％Ｖ２５／ＨＴ＜４５％）。结果：小气道功能重度异常组的病人其单侧、双侧通气时初始气道阻力明显高于小气道功能正常组且术中波动较大，两组间差异非常显著（Ｐ＜０．０１）；术后心肺并发症（２２．２％）明显高于正常组（０）及轻度异常组（６．６％）。结论：在预测双腔管全麻下气道阻力变化的小气道功能指标中以％ＦＥＶ１可靠性较好，而％Ｖ２５／ＨＴ因较敏感而可靠性较差。
Aim:This study was conducted to investigate the correlation between the preoperative small airway function and the changes of airway resistance during thoracotomy under general anaesthesia in patients with esophageal carcinoma.Clinical material and methods:Between Oct.1995 to Jun.1996,93 patients with esophageal carcinoma were divided into three groups according to preoperative pulmonary function:group A(n=41) with almost normal small airway function(VC%≥80%、%FEV 1≥70%、%V 25 /HT≥50%),group B(n=15) with slightly impaired small airway function(VC%≥80%、%FEV 1≥70%、%V 25 /HT=45%～50%) and group C(n=7) with severely impaired small airway function(VC%≥80%、%FEV 1<70%、%V 25 /HT<45%).All patients underwent surgery under the general anaesthesia.Results:It was found that the initial airway resistance during bilateral and unilateral ventilation was much higher and fluctuated evidently due to a great amount of sputum production in group C than in group A and in group B.The difference of airway resistance during bilateral and unilateral ventilation between group C and group A as well as between group C and group B was all statistically significant(P<0.01 or 0.05).It was also found that group C had more postoperative cardiopulmonary complications (22.2%) than group A(0) and group B(6.6%).Conclusion:It can therefor be concluded that comparing with the patients with normal small airway function,the patients with severely impaired small airway function(%FEV 1<70% and %V 25 /HT<45%) will produce higher airway resistance during general anaesthesia and thoracotomy,and usually have higher risk of postoperative cardiopulmonary complications.%FEV 1 is closely correlated with the changes of airway resistance than %V 25 /HT.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
1999年第4期222-225,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
食管癌
肺功能
小气道功能
气道阻力
外科手术
Esophageal carcinoma Pulmonary function Small airway function Airway resistance Surgical treatment
