Zhai Zhenzhou, Zhao Jun, Li Chang, Ding Cheng, Xu Chun
Department of Thoracic Surgery, First Affiliated Hospital of Suzhou University, Suzhou 215006, China.
Department of Neurosurgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200336, China.
Zhongguo Fei Ai Za Zhi. 2022 Jan 20;25(1):21-25. doi: 10.3779/j.issn.1009-3419.2021.103.15.
To investigate the correlation between the reduction of lung volume and the degree of lung function damage after lobectomy.
A total of 131 patients (72 males and 59 females) who underwent thoracoscopic lobectomy in the First Affiliated Hospital of Suzhou University from January 2019 to July 2020 (including thoracoscopic resection of left upper lobe, left lower lobe, right upper lobe, right middle lobe and right lower lobe). In order to compare the difference between postoperative pulmonary function and preoperative pulmonary function, the pulmonary function measurements were recorded at 7 days before operation, and 3 months, 6 months and 1 year after operation. Forced expiratory volume in 1 second (FEV1) was used as the main evaluation parameter of pulmonary function. The original lung volume and the remaining lung volume at each stage were calculated by Mimics Research 19.0 software. The correlation between lung volume and lung function was analyzed.
FEV1 in postoperative patients was lower than that before operation, and the degree of decline was positively correlated with the resection volume of lung lobes (the maximum value was shown in the left lower lobe group). Significantly, there was no significant difference in the degree of pulmonary function reduction between 3 months, 6 months and 1 year after operation.
The decrease of lung tissue volume after lobectomy is the main reason for the decrease of lung function, especially in the left lower lobe. And 3 months after lobectomy can be selected as the evaluation node of residual lung function.
探讨肺叶切除术后肺容积减少与肺功能损害程度之间的相关性。
选取2019年1月至2020年7月在苏州大学附属第一医院行胸腔镜肺叶切除术的131例患者（男72例，女59例）（包括胸腔镜下左上叶、左下叶、右上叶、右中叶及右下叶切除术）。为比较术后肺功能与术前肺功能的差异，分别于术前7天、术后3个月、6个月及1年记录肺功能测量值。采用第1秒用力呼气容积（FEV1）作为肺功能的主要评估参数。运用Mimics Research 19.0软件计算各阶段的原肺容积及剩余肺容积。分析肺容积与肺功能之间的相关性。
术后患者的FEV1低于术前，下降程度与肺叶切除量呈正相关（左下叶组下降值最大）。值得注意的是，术后3个月、6个月及1年肺功能下降程度无显著差异。
肺叶切除术后肺组织容积减少是肺功能下降的主要原因，尤其是左下叶。肺叶切除术后3个月可作为残余肺功能的评估节点。
