Jenkins S C, Soutar S A, Forsyth A, Keates J R, Moxham J
Department of Thoracic Medicine, King's College Hospital, London.
Thorax. 1989 Mar;44(3):209-11. doi: 10.1136/thx.44.3.209.
Lung volumes and arterial blood gas tensions in patients undergoing coronary artery surgery were compared in 77 patients given an internal mammary artery graft (group 1) and 33 patients given a saphenous vein graft only (group 2). Patients in both groups developed a severe restrictive ventilatory defect after surgery, more pronounced in those receiving an internal mammary artery graft. Mean (SEM) vital capacity in groups 1 and 2 was reduced to 36% (1.2%) and 45% (2.0%) of preoperative values on the second postoperative day (1.56 and 1.85 1 respectively), with some recovery by day 4 to 56% (1.2%) and 63% (2.1%) of preoperative values. The mean (SEM) arterial oxygen tension was 7.34 (0.13) kPa for group 1 and 7.46 (0.20) kPa for group 2 on day 2, rising to 8.39 (0.13) and 9.01 (0.23) kPa on day 4. Analgesic requirements were greater in the group receiving an internal mammary artery graft. Possible explanations for the differences between the effects of the two grafts include the higher frequency of pleurotomy, the placing of pleural drains, and additional surgical trauma when internal mammary artery grafts are used.
对77例行乳内动脉移植术的患者（第1组）和33例仅行大隐静脉移植术的患者（第2组）在冠状动脉手术期间的肺容量和动脉血气张力进行了比较。两组患者术后均出现严重的限制性通气功能障碍，在接受乳内动脉移植术的患者中更为明显。术后第2天，第1组和第2组的平均（标准误）肺活量分别降至术前值的36%（1.2%）和45%（2.0%）（分别为1.56和1.85升），到第4天有所恢复，分别为术前值的56%（1.2%）和63%（2.1%）。术后第2天，第1组的平均（标准误）动脉血氧张力为7.34（0.13）kPa，第2组为7.46（0.20）kPa，第4天分别升至8.39（0.13）和9.01（0.23）kPa。接受乳内动脉移植术的组镇痛需求更大。两种移植术效果差异的可能解释包括胸膜切开术频率较高、放置胸腔引流管以及使用乳内动脉移植术时额外的手术创伤。
