Rzyman W, Skokowski J, Romanowicz G, Lass P, Murawski M, Taraszewska M, Dziadziuszko R
Department of Thoracic Surgery, Medical University of Gdansk, Gdansk, Poland.
Thorac Cardiovasc Surg. 2005 Aug;53(4):245-9. doi: 10.1055/s-2005-837646.
To evaluate lung function after lung decortication in patients operated for chronic pleural empyema.
To determine the lung function after lung decortication in 20 men (71.4%) and 8 women (28.6%) a prospective evaluation of blood gases, spirometry, lung perfusion, ventilation, and alveolar permeability were performed 28 weeks (15-60 weeks) after the operation.
Median lung perfusion on the affected side was 45.2% (26.1-55.3%) in 13 right and 36% (13.8-47.2%) in 15 left empyemas, and was within normal limits in 4/28 cases. The mean lung ventilation was 44.4% (21.5-54%) and 37% (18.9-50.6%) in patients affected on the right or left side, respectively. Ventilation perfusion inequality occurred in 22 patients (78.6%). Dynamic ventilation scintigraphy revealed impairment of epithelial integrity in 10 cases (35.7%). Individual analysis revealed that 15 patients (53.6%) showed a severe reduction in one of the examinations and 8 (28.6%) in more than one.
Although the separate analysis of the different functional parameters revealed a mild reduction of lung function after decortication, in the majority of patients the impairment was more severe due to multilevel functional lung damage.
评估因慢性胸膜脓胸接受手术的患者行肺纤维板剥脱术后的肺功能。
为确定20名男性（71.4%）和8名女性（28.6%）行肺纤维板剥脱术后的肺功能，在术后28周（15 - 60周）对血气、肺量计、肺灌注、通气及肺泡通透性进行了前瞻性评估。
13例右侧脓胸患者患侧肺灌注中位数为45.2%（26.1 - 55.3%），15例左侧脓胸患者为36%（13.8 - 47.2%），28例中有4例在正常范围内。右侧或左侧受累患者的平均肺通气分别为44.4%（21.5 - 54%）和37%（18.9 - 50.6%）。22例患者（78.6%）出现通气灌注不均。动态通气闪烁显像显示10例患者（35.7%）上皮完整性受损。个体分析显示，15例患者（53.6%）在一项检查中显示严重降低，8例患者（28.6%）在一项以上检查中显示严重降低。
尽管对不同功能参数的单独分析显示纤维板剥脱术后肺功能有轻度降低，但在大多数患者中，由于肺功能的多级损害，损伤更为严重。
