Ferdinande P G, Beets G, Michels A, Lesaffre E, Lauwers P
Department of Surgical Intensive Care, Gasthuisberg University Hospital, K.U. Leuven, Belgium.
Intensive Care Med. 1988;14(6):623-7. doi: 10.1007/BF00256766.
Pulmonary function tests were measured in 33 male patients undergoing elective coronary artery bypass surgery. Three modes of surgical technique were used: Bilateral internal mammary artery graft (BIMA), single internal mammary artery graft (SIMA) and saphenous vein grafts (VS). Following parameters were recorded: patient's age, length, body weight, preoperative forced vital capacity (FVC) and forced expiratory volume at one second (FEV 1), preoperative end-diastolic pressure and function of the left ventricle, smoking habitus, the fact that the pleural cavity was entered, duration of the cardiopulmonary bypass period, perioperative fluid balance and postoperative FVC and FEV 1 on the first eight postoperative days. In the BIMA group two pleural cavities, the SIMA group one pleural sac and the VS group none of the pleural cavities was entered. The BIMA group was younger (50.1 +/- 7.6 versus 57.7 +/- 7.28 and 60.1 +/- 6.9 years (p less than 0.05)) than the SIMA and VS group. Postoperative external blood loss was lower in the VS group compared to the SIMA and BIMA groups (839 +/- 255 ml versus 1346 +/- 654 ml and 1259 +/- 396 ml (p less than 0.05)). The FVC shows a dramatic decrease especially on the second postoperative day and was most markedly diminished in the BIMA and SIMA compared to VS (31% +/- 9% and 35% +/- 8% versus 45% +/- 10% of preoperative values (p less than 0.05)).(ABSTRACT TRUNCATED AT 250 WORDS)
对33例行择期冠状动脉搭桥手术的男性患者进行了肺功能测试。采用了三种手术技术方式:双侧乳内动脉移植术(BIMA)、单乳内动脉移植术(SIMA)和大隐静脉移植术(VS)。记录了以下参数:患者年龄、身高、体重、术前用力肺活量(FVC)和一秒用力呼气量(FEV₁)、术前左心室舒张末期压力和功能、吸烟习惯、是否进入胸腔、体外循环时间、围手术期液体平衡以及术后前八天的FVC和FEV₁。BIMA组进入两个胸腔,SIMA组进入一个胸腔,VS组未进入胸腔。BIMA组比SIMA组和VS组年轻(分别为50.1±7.6岁、57.7±7.28岁和60.1±6.9岁,p<0.05)。与SIMA组和BIMA组相比,VS组术后外出血量更低(分别为839±255ml、1346±654ml和1259±396ml,p<0.05)。FVC显著下降,尤其是在术后第二天,与VS组相比,BIMA组和SIMA组下降最为明显(分别为术前值的31%±9%和35%±8%,而VS组为45%±10%,p<0.05)。(摘要截选至250字)