Koike T, Hirono T, Takizawa T, Yamato Y, Souma T, Yoshiya K, Nakayama K, Tsuchida M, Eguchi S
Nihon Kyobu Geka Gakkai Zasshi. 1989 Sep;37(9):1889-92.
From January 1975 to December 1986, 415 patients were operated for primary lung cancer. Postoperative pulmonary complications were observed in 83 patients and among them 48 patients (57.8%) suffered from difficulty in expectoration. Postoperative expectoration mostly depends on the ability of coughing. To evaluate cough dynamics, expiratory flow-rate and volume at voluntary maximal cough were measured. The more expiratory flow rate and volume a cough has, the more effective it is for expectoration. In those patients with decreased FEV1.0, or respiratory muscle weakness because of emaciation and aging, or severe pain in the wound, the cough dynamics was decreased. By cleaning retained secretions in the respiratory tract, postoperative pulmonary complications would be prevented. However in cases where the decrease in postoperative cough dynamics is predictable, application of limited resection should be considered as well.
1975年1月至1986年12月期间，415例患者接受了原发性肺癌手术。83例患者出现了术后肺部并发症，其中48例患者（57.8%）咳痰困难。术后咳痰主要取决于咳嗽能力。为评估咳嗽动力学，测量了自主最大咳嗽时的呼气流量和容积。一次咳嗽的呼气流量和容积越大，咳痰效果越好。在那些第一秒用力呼气量（FEV1.0）降低、因消瘦和衰老导致呼吸肌无力或伤口剧痛的患者中，咳嗽动力学降低。通过清除呼吸道内潴留的分泌物，可以预防术后肺部并发症。然而，在术后咳嗽动力学降低可预测的情况下，也应考虑应用有限切除术。
