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结核性和非结核性慢性脓胸行脓胸切除及纤维板剥脱术后肺功能的变化

Change in pulmonary function following empyemectomy and decortication in tuberculous and non-tuberculous chronic empyema thoracis.

作者信息

Choi Sung-Sil, Kim Dae-Joon, Kim Kil-Dong, Chung Kyung-Young

机构信息

Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Korea.

出版信息

Yonsei Med J. 2004 Aug 31;45(4):643-8. doi: 10.3349/ymj.2004.45.4.643.

Abstract

Chronic empyema thoracis results from various etiologies. Improvement in pulmonary function after empyemectomy and decortication has proved difficult to predict when the etiology of chronic empyema thoracis is tuberculosis. The purpose of this study was to confirm the changes in pulmonary function according to the etiology after an operation. Sixty-five patients were classified into two groups according to their etiology: Group A (tuberculous) and Group B (non-tuberculous), and they were retrospectively evaluated with regard to their forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), percentage of predicted normal value of FEV1 (% FEV1) and FVC (%FVC). Empyemectomy and decortication was performed for all the patients and the two groups were similar in age, gender and preoperative spirometric parameters. In Group A (n=41), the pre- and postoperative mean values were 2.31 L and 2.8 L in FEV1, 65.8% and 80.5% in %FEV1, 2.62 L and 2.55 L in VC, 61.9% and 71.8% in %VC, respectively. In Group B (n=24), the pre- and postoperative mean values were 2.13 L and 2.49 L in FEV1, 66.4% and 73.8% in %FEV1, 2.55 L and 2.95 L in FVC, 64.9% and 71.8% in %FVC, respectively. All the spirometric parameters improved significantly in both groups compared to their preoperative values. However, no significance was shown in the rate of increase of the spirometric parameters between the two groups. In conclusion, improvement of lung function is expected after empyemectomy and decortication, regardless of the etiology of the chronic empyema thoracis.

摘要

慢性脓胸由多种病因引起。当慢性脓胸的病因是肺结核时,肺叶切除加胸膜纤维板剥脱术后肺功能的改善情况很难预测。本研究的目的是证实手术后根据病因不同肺功能的变化。65例患者根据病因分为两组:A组(结核性)和B组(非结核性),回顾性评估其第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1预测正常值百分比(%FEV1)和FVC预测正常值百分比(%FVC)。所有患者均接受了肺叶切除加胸膜纤维板剥脱术,两组患者在年龄、性别和术前肺量计参数方面相似。A组(n = 41)中,FEV1术前和术后的平均值分别为2.31 L和2.8 L,%FEV1分别为65.8%和80.5%,VC分别为2.62 L和2.55 L,%VC分别为61.9%和71.8%。B组(n = 24)中,FEV1术前和术后的平均值分别为2.13 L和2.49 L,%FEV1分别为66.4%和73.8%,FVC分别为2.55 L和2.95 L,%FVC分别为64.9%和71.8%。与术前值相比,两组所有肺量计参数均显著改善。然而,两组肺量计参数的增加率无显著差异。总之,无论慢性脓胸的病因如何,肺叶切除加胸膜纤维板剥脱术后肺功能有望改善。

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