肺癌患者肺切除术后右心功能及肺功能的改变

目的观察肺癌患者肺切除术后右心功能及肺功能的改变。方法回顾性分析本院肺切除术的肺癌患者85例临床资料,比较肺叶切除及全肺切除术后右心功能及肺功能的改变。结果术后第3天,2组平均动脉压（mPAP）、心率（HR）及右心室舒张末期容积指数（RVEDVI）均较术前显著增加（P〈0.01）,右心室射血分数（RVEF）较术前显著降低（P〈0.01）;术后第3天,肺叶切除组PaO2水平较术前显著下降（P〈0.01）,术后第8天,PaO2恢复至接近术前水平。全肺切除组各指标变化较肺叶切除组更加明显（P〈0.05或P〈0.01）。全肺切除组肺功能下降百分比较肺叶切除组更明显（P〈0.01）。结论与肺叶切除术比较,全肺切除术右心功能及肺功能下降较为明显,建议在保证彻底切除病灶的基础上,应最大限度地保留正常肺组织,以减少手术并发症,改善生活质量。

Changes of right heart ventricular function and lung function after pulmonary resection in patients with lung cancer

Objective To observe the changes of right heart ventricular function and lung function after pulmonary resection in patients with lung cancer.Methods The clinical data of 85 patients with lung cancer who received pulmonary resection in our hospital were retrospectively analyzed.Results The mPAP,HR and RVEDVI in both groups increased noticeably 3 days after operation（P〈0.01）,while the RVED decreased more significantly（P〈0.01）.The level of PaO2 in the lobectomy group decreased markedly 3 days after operation（P〈0.01）,while it nearly recovered to the level before operation.The changes of index in the pneumonectomy group were more significant than those in the lobectomy group（P〈0.05 or P〈0.01）.The decreasing rate of lung function in the pneumonectomy group was more significant than that in the lobectomy group（P〈0.01）.Conclusion Compared with the pulmonary lobectomy,the decreasing of right heart ventricular function and lung function of pneumonectomy was more significant.It is suggested to keep normal lung tissue as much as possible based on removing lesions completely,so as to reduce the complications and improve the quality of life.