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[肺切除术前评估中采用单侧肺动脉闭塞试验时右心室功能的变化]

[Changes in right ventricular function with unilateral pulmonary artery occlusion test for pre-operative evaluation prior to lung resection].

作者信息

Sagara Y, Shiroishi Y, Hayashi K, Komatsu H, Murakami K, Mohri M, Katayama T

机构信息

Department of Thoracic Surgery, Tokyo National Chest Hospital, Japan.

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1992 Mar;30(3):425-9.

PMID:1569720
Abstract

We measured the right ventricular ejection fraction (RVEF) before and during unilateral pulmonary artery occlusion test (UPAO) by thermodilution method. We also measured the right ventricular end-diastolic volume index (RVEDVI), right ventricular end-systolic volume index (RVESVI), and right ventricular stroke volume index (RVSVI). RVEF and RVSVI were significantly decreased by UPAO (p less than 0.05), but there were no obvious changes in RVEDVI and RVESVI. Some cases showed only a small decrease in RVEF by UPAO, even though their total pulmonary vascular resistance indices were over 700 dyne.sec.cm-5/m2 during UPAO. On the other hand, some cases had a decreased in RVEF of more than 10% by UPAO, even though their total pulmonary vascular resistance indices were under 400 dyne.sec.cm-5/m2 during UPAO. We consider that it is important to measure right ventricular functions such as RVEF together with pulmonary vascular hemodynamics in the pre-operative evaluation of cases of lung resection.

摘要

我们通过热稀释法在单侧肺动脉闭塞试验(UPAO)之前及期间测量右心室射血分数(RVEF)。我们还测量了右心室舒张末期容积指数(RVEDVI)、右心室收缩末期容积指数(RVESVI)和右心室每搏输出量指数(RVSVI)。UPAO使RVEF和RVSVI显著降低(p小于0.05),但RVEDVI和RVESVI无明显变化。一些病例尽管在UPAO期间其总肺血管阻力指数超过700达因·秒·厘米⁻⁵/平方米,但UPAO导致RVEF仅小幅下降。另一方面,一些病例尽管在UPAO期间其总肺血管阻力指数低于400达因·秒·厘米⁻⁵/平方米,但UPAO使RVEF下降超过10%。我们认为在肺切除病例的术前评估中,将RVEF等右心室功能与肺血管血流动力学一起测量很重要。

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