Milledge J S, Nunn J F
Br Med J. 1975 Sep 20;3(5985):670-3. doi: 10.1136/bmj.3.5985.670.
Twelve patients with severe chronic obstructive lung disease undergoing 15 operations were assessed with preoperative lung function tests and blood gas estimations. Their operative and postoperative course was followed. There were no deaths or serious complications. Patients fell into three groups: those with low respiratory capacity but normal blood gases, who required no special respiratory treatment apart from physiotherapy and antibiotics; those with hypoxaemia but normal arterial carbon dioxide pressure, who needed more prolonged oxygen treatment after operation; and those with hypoxaemia and hypercapnia, who needed postoperative ventilatory support. While forced expiratory volume in one second (FEV) is a good screening test in preoperative assessment it should be supplemented by arterial blood gas estimations in patients with an FEV of less than 1 litre.
对12例患有严重慢性阻塞性肺疾病且接受了15次手术的患者进行了术前肺功能测试和血气评估。记录了他们的手术过程及术后病程。无死亡病例或严重并发症。患者分为三组：呼吸能力低但血气正常的患者，除物理治疗和抗生素外无需特殊呼吸治疗；存在低氧血症但动脉二氧化碳分压正常的患者，术后需要更长时间的吸氧治疗；存在低氧血症和高碳酸血症的患者，术后需要通气支持。虽然一秒用力呼气量（FEV）在术前评估中是一项很好的筛查测试，但对于FEV小于1升的患者，应辅以动脉血气评估。
