| 膈肌移动度与肺切除术后肺部并发症及近期预后的关系 |
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| 引用本文： | 岳红,王小文,李林峻,张勇,陈丹,吴庆琛,贺雪梅. 膈肌移动度与肺切除术后肺部并发症及近期预后的关系[J]. 临床超声医学杂志, 2021, 23(4): 276-279 |
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| 作者姓名： | 岳红 王小文 李林峻 张勇 陈丹 吴庆琛 贺雪梅 |
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| 作者单位： | 400016 重庆市,重庆医科大学附属第一医院超声科;400016 重庆市,重庆医科大学附属第一医院胸心外科 |
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| 基金项目： | 医院学术带头人储备人才基金项目(xkts060)。 |
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| 摘 要： | 目的 应用超声测量膈肌移动度,分析其与肺切除术后肺部并发症和近期预后的关系,探讨导致膈肌功能障碍的危险因素.方法 选取我院胸外科行单侧肺切除术的患者90例,应用床旁超声分别于术前和术后24 h、48 h、72 h监测患者双侧膈肌移动度.根据术后膈肌移动度分为膈肌功能障碍组(DD组)54例和膈肌功能正常组(ND组)36例...
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| 关 键 词： | 超声检查 膈肌移动度 肺切除术 预后 |
Relationship between diaphragmatic excursion and pulmonary complications and short-term prognosis after pneumonectomy |
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| YUE Hong,WANG Xiaowen,LI Linjun,ZHANG Yong,CHEN Dan,WU Qingchen,HE Xuemei. Relationship between diaphragmatic excursion and pulmonary complications and short-term prognosis after pneumonectomy[J]. Journal of Ultrasound in Clinical Medicine, 2021, 23(4): 276-279 |
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| Authors: | YUE Hong WANG Xiaowen LI Linjun ZHANG Yong CHEN Dan WU Qingchen HE Xuemei |
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| Affiliation: | (Department of Ultrasound,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China) |
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| Abstract: | Objective To measure the diaphragmmtic excursion by ultrasound,and to analyze its relationship with postoperative pulmonary complications and short-term prognosis,to explore the risk factors leading to diaphragm dysfunction.Methods Ninety patients of unilateral pneumonectomy in thoracic surgery of our hospital were collected.Diaphragmatic excursion was measured sequentially for each patient before and 24 h,48 h,and 72 h after operation by bedside ultrasound.According to the postoperative diaphragmatic excursion,the patients were divided into diaphragm dysfunction group(DD group,n=54)and Normal diaphragmatic function group(ND group,n=36).The differences of the incidence of postoperative pulmonary complications and short-term prognosis between the two groups were compared.Logistic regression was used to analysis the risk factors leading to diaphragm dysfunction.Results The incidence of postoperative pulmonary complications(atelectasis,postoperative residual cavity,pleural effusion,and lung infection)in the DD group were higher than those in the ND group,and the differences were statistically significant(all P<0.05).The short-term prognosis of the DD group(the time to complete lung recruitment and post-operative catheterization)were worse than those of the ND group,the difference were statistically significant(both P<0.05).In both groups,diaphragmatic excursion first decreased and then increased on the operative side,while it remained unchanged on the opposite side at 48 h after operation and increased compensatively from 72 h after operation.Logistic regression analysis showed that smoking history and lobectomy were risk factors for postoperative diaphragmatic dysfunction(OR=4.347,3.153,both P<0.05).Conclusion Diaphragmatic dysfunction after pneumonectomy leads to higher incidence of pulmonary complications,which is not conducive to short-term prognosis.Bedside ultrasound can be used to measure the diaphragmatic excursion during peri-operative period,and early detection of diaphragm dysfunction,which can provide help for clinical strategies. |
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| Keywords: | Ultrasonography Diaphragmatic excursion Pneumonectomy Prognosis |
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