Van Mieghem W, Demedts M
Pulmonary Division, University Hospital, Catholic University Leuven, Belgium.
Respir Med. 1989 May;83(3):199-206. doi: 10.1016/s0954-6111(89)80032-0.
Resection of pulmonary tissue for bronchial carcinoma causes a decrease in vital capacity of 15% after lobectomy and 35-40% following pneumonectomy. After operation the lung becomes stiffer and elastic recoil pressure and transdiaphragmatic pressure at TLC increase. Maximum effort tolerance decreases after pneumonectomy with a normal pulmonary artery pressure at rest and an increase in pulmonary artery pressure and in pulmonary vascular resistance on effort, compared to preoperative values. Cardiac output and stroke volume during effort show a decrease after operation with an increase in peripheral arterial blood pressure and in peripheral vascular resistance. Arterial oxygen saturation on effort decreases after pneumonectomy, possibly due to the absolute decrease in diffusing capacity. When comparing resting and exercise values at identical work loads, increases in systemic arterial blood pressure, pulmonary and systemic vascular resistance and arteriovenous oxygen difference were similar although generally less pronounced after lobectomy compared to pneumonectomy; cardiac output, stroke volume and oxygen consumption showed the same tendency to decrease after lobectomy and pneumonectomy.
支气管癌肺组织切除术导致肺叶切除术后肺活量下降15%，全肺切除术后下降35 - 40%。术后肺变硬，肺总量时的弹性回缩压和跨膈压增加。全肺切除术后，静息时肺动脉压正常，但用力时肺动脉压和肺血管阻力增加，最大用力耐力下降，与术前值相比，用力时心输出量和每搏输出量术后减少，外周动脉血压和外周血管阻力增加。全肺切除术后用力时动脉血氧饱和度下降，可能是由于弥散能力绝对下降所致。在相同工作负荷下比较静息和运动值时，全身动脉血压、肺血管和体循环血管阻力以及动静脉氧差的增加相似，尽管与全肺切除术相比，肺叶切除术后通常不太明显；肺叶切除术和全肺切除术后心输出量、每搏输出量和耗氧量均有相同的下降趋势。
