纵隔气肿对人体心肺功能的影响

目的 探讨纵隔气肿对人体心肺功能的影响。方法 回顾分析了1991年2月～2002年1月收治的33例纵隔气肿患者的临床资料。治疗方法主要为锁骨切迹上切开引流、纵隔引流和胸腔闭式引流。观察治疗前后的血流动力学和血气变化。结果 纵隔气肿使上、下腔静脉压升高，回心血量减少，心排量下降。纵隔气肿不仅影响体循环，而且影响肺循环，使肺瘀血、水肿，动脉血氧分压和血氧饱和度下降，肺内分流增加。结论 纵隔气肿严重影响患者心肺功能，应早期诊断、及时处理。

Impact of pneumomediastinum on cardiopulmonary function

Objective To investigate the influence of pneumomediastinum on cardiopulmonary function. Methods Thirty three patients with pneumomediastinum were treated from February 1991 to January 2002.Changes of the hemodynamics and blood gases after treatment were observed. Results After pneumomediastinum(PM),as compared with the baseline measurements,the venacaval pressure raised and the cardiac output decreased significantly. These results suggests that PM compresses the vena cava,the pulmonary vein and the heart. It induces a decrease of venous return to the heart and a deterioration of cardiac function. Measurments of blood gases also changed significantly in company with a decrease of PaO 2 and an increase of Qs/Qt. Conclusion Pneumomediastinum influences cardiopulmonary function seriously,early diagnose and treatment is mandatory.