Dureuil B, Cantineau J P, Desmonts J M
Département d'Anesthésie-Réanimation, Hôpital Bichat, Paris, France.
Br J Anaesth. 1987 Oct;59(10):1230-5. doi: 10.1093/bja/59.10.1230.
Changes in abdominal (delta AB) and rib cage (delta RC) movements, and in vital capacity, were compared between 23 patients undergoing upper or lower abdominal surgery at 1, 3 and 7 days after surgery. Diaphragmatic index was obtained by measuring the relative abdominal motion (delta AB/delta AB + delta RC) using magnetometers. Electrical activity of abdominal muscles was assessed using needle electrodes after upper abdominal surgery in four additional patients. After upper abdominal surgery, the vital capacity and the diaphragmatic index were markedly reduced for 1 week. No abdominal muscle activity was observed at day 1. After lower abdominal surgery, the vital capacity returned to the normal range within 3 days of operation, without any diaphragmatic impairment. These findings substantiate the role of diaphragmatic dysfunction in postoperative reduction in vital capacity observed after upper abdominal surgery.
对23例接受上腹部或下腹部手术的患者在术后1天、3天和7天的腹部（δAB）和胸廓（δRC）运动变化以及肺活量进行了比较。通过使用磁力计测量相对腹部运动（δAB/δAB + δRC）来获得膈肌指数。另外4例接受上腹部手术的患者术后使用针电极评估腹部肌肉的电活动。上腹部手术后，肺活量和膈肌指数在1周内显著降低。术后第1天未观察到腹部肌肉活动。下腹部手术后，肺活量在术后3天内恢复到正常范围，且无膈肌功能障碍。这些发现证实了膈肌功能障碍在上腹部手术后观察到的肺活量降低中的作用。
