全肺切除时肺功能的评价及意义

目的探讨术前肺功能检查对评价全肺切除病人耐受性的意义。方法总结119例全肺切除术，术前根据FEV1、MVV及其占预计值比例、PPOFEV1、血气分析（特别是PCO2）结果及临床资料综合判断病人的耐受力。并强调完善的围术期处理。结果全组术后发生并发症29例（24．4％，其中肺部感染并发症13例，室上性心律失常9例，上消化道出血4例，心脏疝2例，二次开胸止血1例），住院死亡4例（3．1％，上消化道大出血2例，心跳骤停1倒，心脏疝1例），其余病例顺利出院。结论综合正确评价肺功能及病人的耐受性，积极的围术期准备既可避免让一些患者失去手术治疗机会，又能减少术后并发症及死亡率。

Assessment and clinical meaning of pulmonary function in pneumonectomy

Objective] To analyze the assessment and clinical meaning of the preoperative pulmouary function in pneumonectomy. Methods] 119 of pneumo nectomy, preoperative evaluation by FEV1 (forced expiratory volume in 1 second), MVV (Maximal voluntary ventilation), PPOFEV1 (predicted postoperative FEV1), Arterial blood gas analysis and clinical information, the management of preoperation and postoperation is very important. Results] 29 patients (24.4%) had postoperative complication, 4 patients (3.1%) were death and other patients were cured. Conclusion] To decrease the post operative complication and mortality, the assessment of the preoperative pulmonary function in pneamonectomy is the key.