Westerdahl E, Lindmark B, Bryngelsson I, Tenling A
Department of Physiotherapy and Thoracic Surgery, Orebro University Hospital, Orebro, Sweden.
Respir Med. 2003 Apr;97(4):317-22. doi: 10.1053/rmed.2002.1424.
The objective of this study was to describe the pulmonary function and pain 4 months after coronary artery bypass graft surgery. Twenty-five male patients performed pulmonary function tests before surgery, on the 4th postoperative day and 4 months after surgery. A severe reduction in pulmonary function was present after surgery. Four months postoperatively, the patients still showed a significant decrease (6-13% of preoperative values) in vital capacity (P<0.001), inspiratory capacity (P<0.001), forced expiratory volume in 1 s (P<0.001) peak expiratory flow rate (P<0.001), functional residual capacity (P=0.05) total lung capacity (P<0.001) and single-breath carbon monoxide diffusing capacity (P<0.01). Residual volume and single-breath carbon monoxide diffusing capacity per litre of alveolar volume had returned to the preoperative level. Four months postoperatively, the median values for sternotomy pain while taking a deep breath was 0.2 and while coughing 0.3 on a 10 cm visual analogue pain scale. In conclusion, a significant restrictive pulmonary impairment persisting up to 4 months into the postoperative period was found after CABG. Measured levels of pain were low and could not explain the impairment.
本研究的目的是描述冠状动脉搭桥手术后4个月的肺功能和疼痛情况。25名男性患者在手术前、术后第4天和术后4个月进行了肺功能测试。术后肺功能出现严重下降。术后4个月,患者的肺活量(P<0.001)、吸气量(P<0.001)、第1秒用力呼气量(P<0.001)、呼气峰值流速(P<0.001)、功能残气量(P=0.05)、肺总量(P<0.001)和单次呼吸一氧化碳弥散量(P<0.01)仍显著低于术前值(术前值的6-13%)。残气量和每升肺泡容积的单次呼吸一氧化碳弥散量已恢复到术前水平。术后4个月,在10厘米视觉模拟疼痛量表上,深呼吸时胸骨切开术疼痛的中位数为0.2,咳嗽时为0.3。总之,冠状动脉搭桥术后发现术后4个月内持续存在明显的限制性肺功能损害。测得的疼痛程度较低,无法解释这种损害。