Derveaux L, Ivanoff I, Rochette F, Demedts M
Clinic of Lung Disease, University Hospitals, Catholic University, Leuven, Belgium.
Eur Respir J. 1988 Oct;1(9):823-5.
In 24 subjects with pectus excavatum we evaluated whether the previously detected unfavourable effects of corrective surgery on the ventilatory capacity were attributable to pulmonary or to chest wall factors. We found that 12.2 +/- 3.7 yrs postoperatively (i.e. at the age of 23.3 +/- 5.4 yrs) the vital capacity was decreased from 89 +/- 10% predicted (pred) preoperatively to 64 +/- 6% pred (p less than 0.001) and forced expiratory volume in one second from 88 +/- 17 to 66 +/- 11% pred (p less than 0.001). At total lung capacity (TLC; 69 +/- 5% pred) we found an obvious reduction in transpulmonary pressure (59 +/- 23% pred) and in transdiaphragmatic pressure (30 +/- 17 cmH2O) postoperatively. This indicated an extrapulmonary cause of the restrictive defect, attributable to abnormal chest wall mechanics secondary to the extensive surgery on the sternum and parasternal zones.
在24名漏斗胸患者中，我们评估了先前检测到的矫正手术对通气能力的不利影响是归因于肺部因素还是胸壁因素。我们发现，术后12.2±3.7年（即23.3±5.4岁时），肺活量从术前预测值的89±10%降至64±6%（p<0.001），一秒用力呼气量从88±17%降至66±11%（p<0.001）。在肺总量（TLC；69±5%预测值）时，我们发现术后跨肺压（59±23%预测值）和跨膈压（30±17cmH₂O）明显降低。这表明限制性缺陷的肺外原因，归因于胸骨和胸骨旁区域广泛手术后胸壁力学异常。
