进胸取膈神经移位术后肺功能的变化

目的　研究进胸取膈神经移位术后患者肺功能的变化。方法　对 5例进胸取膈神经移位患者术前及术后 (8～ 14个月 )肺功能的变化进行比较。结果　 5例在术后均未出现供氧不足症状。 3例出现膈肌抬高 ;术后肺活量 (VC)、肺活量预计值百分数 (VC % )分别比术前减少 17.3 %和 3 2 .3 % ,两者差异有显著性意义 (tvc=3 .49、tvc% =4.17,P <0 .0 5 )。其它项目如残气量 (RV)、肺总量 (TLC)、残气量 /肺总量比值 (RV/TLC)、用力肺活量 (FVC)、1s用力呼气量 (FEV1)、1s用力呼气量 /用力肺活量比值(FEV1/FVC)、5 0 %肺活量的最大呼气流量预计值百分数 (FEF 5 0 % )的变化 ,和术前相比均无明显差异。结论　进胸取膈神经移位术后成人的肺容量有部分丧失 ,但其丧失程度在机体可耐受范围内 ,不会导致呼吸功能障碍

The change of the respiratory function after transfer of phrenic nerve harvested from thoracic cavity

Objective To study the change of the respiratory function in patients after transfer of phrenic nerve harvested from thoracic cavity. Methods Five adult patients of brachial plexus injuries who underwent transfer of phrenic nerve harvested from thoracic cavity by thoracotomy were involved. Preoperative and postoperative (8 to 14 months) pulmonary function were compared. Results Postoperatively,none of these patients developed any clinic symptoms of respiratory insufficiency; three patients demonstrated hemidiaphragm elevation at the operation side on radiography; vital capacity (VC) and percentage of predicted value of vital capacity (VC %) decreased 17.3 % and 32.3 % on average respectively. There was statistical significant difference. No statistical significant difference existed among residual volume(RV), total lung capacity(TLC), ratio of RV and TLC (RV/TLC), forced vital capacity (FVC), forced expiratory volume at 1.0 second (FEV1), ratio of FEV1 and FVC (FEV1/FVC), and percentage of predicted value of forced expiratory flow at 50 % of maximum vital volume (FEF 50 %),when compared with those before operation. Conclusions Transfer of phrenic nerve harvested from thoracic cavity in adult led to reduction in lung volume, but which was not beyond the tolerance of the patients and may not lead to respiratory dysfunction.