Larsson A, Jonmarker C, Werner O
Department of Anaesthesia, University Hospital, Lund, Sweden.
Acta Chir Scand. 1989 Jun-Jul;155(6-7):329-32.
Functional residual capacity (FRC) and breath-by-breath compliance of the respiratory system (Crs) were studied after induction of anaesthesia, after insertion of retractors and after wound closure in patients undergoing upper abdominal surgery via a subcostal (n = 8) or a midline (n = 8) incision. After anaesthesia induction the mean FRC was 1.6 +/- 0.3 l. In the subcostal incision group FRC did not change between the studied stages, but Crs fell after retractor placement from 51 +/- 3 to 43 +/- 5 ml/cmH2O (p less than 0.01). In the midline incision group FRC rose by 21% (p less than 0.01) when the retractors were inserted, but regained outset level after wound closure. Crs in this group did not change significantly after retraction, but after closure of the wound it fell to 44 +/- 6 ml/cmH2O, i.e. less (p less than 0.05) than the outset value (52.6 ml/cmH2O). FRC thus did not decrease in either group, but Crs fell by about 15%. The authors conclude that the known difference in postoperative pulmonary complications between midline vs. subcostal incisions is not caused by the studied intraoperative events.
通过肋下切口（n = 8）或正中切口（n = 8）进行上腹部手术的患者，在麻醉诱导后、牵开器插入后以及伤口缝合后，研究了功能残气量（FRC）和呼吸系统逐次呼吸顺应性（Crs）。麻醉诱导后，平均FRC为1.6±0.3升。在肋下切口组中，FRC在研究阶段之间没有变化，但在放置牵开器后，Crs从51±3降至43±5毫升/厘米水柱（p<0.01）。在正中切口组中，插入牵开器时FRC上升了21%（p<0.01），但伤口缝合后恢复到初始水平。该组中Crs在牵开后没有显著变化，但伤口缝合后降至44±6毫升/厘米水柱，即低于（p<0.05）初始值（52.6毫升/厘米水柱）。因此，两组的FRC均未降低，但Crs下降了约15%。作者得出结论，正中切口与肋下切口术后肺部并发症的已知差异不是由所研究的术中事件引起的。
