Chou Shah-Hwa, Chuang Hung-Yi, Kao Eing-Long, Huang Ming-Shyang, Hwang Jhi-Jhu, Wang Tung-Heng, Huang Meei-Feng
Department of Surgery, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
Kaohsiung J Med Sci. 2004 Nov;20(11):533-7. doi: 10.1016/S1607-551X(09)70254-2.
The improvement in lung function, exercise test, blood gas levels, and symptoms in emphysema patients after volume reduction surgery is a result of improvements in breathing mechanics. The question is, is the improvement in the condition related to pulmonary hemodynamics? Few studies have examined pre- and postoperative pulmonary pressure. This paper examines whether there is any significant change in systolic and diastolic pulmonary pressure after effective volume reduction surgery. From October 1999 to October 2002, 12 emphysema patients who underwent volume reduction surgery were studied. Systolic and diastolic pulmonary pressures were measured 2 days before surgery through cardiac catheterization and 2 days after removal of the chest tubes through Swan Ganz catheters placed in the operating room just before surgery. Patients were stable and breathed without assistance during the postoperative pressure measurement. Blood gas analysis, lung function tests, and a 6-minute walk test were performed preoperatively and 3 months postoperatively. The two sets of data were compared using the Wilcoxon signed rank test. There was no significant change in pulmonary hemodynamics, although pulmonary function improved. The improvement in pulmonary function after volume reduction surgery is not related to pulmonary hemodynamics.
肺减容术后肺气肿患者的肺功能、运动试验、血气水平及症状改善是呼吸力学改善的结果。问题在于，病情改善是否与肺血流动力学有关？很少有研究检测术前和术后的肺动脉压力。本文研究有效肺减容术后收缩期和舒张期肺动脉压力是否有显著变化。1999年10月至2002年10月，对12例行肺减容术的肺气肿患者进行了研究。术前2天通过心导管插入术测量收缩期和舒张期肺动脉压力，术前在手术室通过放置Swan Ganz导管，术后拔除胸管2天后再次测量。术后压力测量时患者情况稳定，无需辅助呼吸。术前和术后3个月进行血气分析、肺功能测试及6分钟步行试验。两组数据采用Wilcoxon符号秩检验进行比较。尽管肺功能有所改善，但肺血流动力学无显著变化。肺减容术后肺功能的改善与肺血流动力学无关。
